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BLOSSOM OB/GUN & INFERTILITY Marjorie A. Corners, MD FA COG 420 The Parkway, Suite C, Greer, SC 29650 Phone: 8646625000 Fax: 8646625008MEDICAL RECORDS RELEASE Patient Name: SSN: Date of Birth: Address:
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Step 1: Collect all necessary personal information such as name, date of birth, contact information, and insurance details.
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Blossom OBGYN & Infertility is a medical practice specialized in obstetrics, gynecology, and infertility treatments.
All patients and clients who receive services from Blossom OBGYN & Infertility are required to have their information filed in the system.
To fill out Blossom OBGYN & Infertility forms, patients need to provide accurate personal and medical information during their visits.
The purpose of Blossom OBGYN & Infertility is to provide quality medical care and fertility treatments to patients in need.
Information such as personal details, medical history, insurance information, and treatment plans must be reported on Blossom OBGYN & Infertility forms.
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