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ROTOR UA MEDICAL GROUP Po Box 1424, RotoruaPh 07 347 0000 Fax 07 347 4111admin.rm graphs.org.NZ www.rotoruamedical.co.nz EDI: roomed CENTRAL HEALTH, 1181 Ammonia Street, Motorcade Anne Walsh Dr Roger
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To fill out the Rotorua Medical Group form, follow these steps:
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Start by writing your personal information, such as your name, address, and contact details.
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Next, provide your medical history, including any pre-existing conditions, allergies, and current medications.
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Indicate whether you have any specific medical concerns or reasons for seeking medical assistance.
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If applicable, provide details of your primary healthcare provider or any specialist you have been seeing.
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Make sure to accurately fill out the insurance information section, including your policy number and provider.
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If you have any emergency contact information, include it in the designated area.
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Review the form for completeness and accuracy before submitting it to Rotorua Medical Group.
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If there are any additional documents or attachments required, ensure they are included with the form.
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Sign and date the form to validate your submission.
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Finally, submit the completed form to Rotorua Medical Group through the provided channels, such as in person or via online submission.

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