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Date:Colombia Medical Practice 83 Colombia Road, Cassock. Please Circle:Seeing Dr:Registration Details Mr / Mrs / Ms / Miss / Master/ Operate of Birth: First Name: Middle Name: Surname: Preferred
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How to fill out wollombi medical practice
01
Start by entering your personal information, such as your name, date of birth, and contact details.
02
Next, provide your medical history, including any pre-existing conditions, allergies, and current medications.
03
Fill out the patient consent form, which outlines your agreement to receive medical treatment and share your medical information with other healthcare providers.
04
If applicable, provide details of your insurance coverage or any government assistance programs you are enrolled in.
05
Specify the reason for your visit and any specific symptoms or concerns you would like to discuss with the medical practitioner.
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Finally, review the completed form to ensure all information is accurate and sign and date it.
07
Submit the filled-out form to the receptionist or healthcare provider at Wollombi Medical Practice.
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Anyone residing in or visiting the Wollombi area who requires medical care or consultation.
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