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Oregon Health Policy and Research Capitol Project Reporting Form (CPR1) Reporting Entity Identification and Contact Facility Name: Federal Tax ID#: Address: City:Legacy Mount Hood Medical Center 930591528 24800
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Legacy Mount Hood Medical is a form used to report medical information for individuals who receive healthcare services at Legacy Mount Hood Medical Center.
Patients or their authorized representatives are required to fill out and submit the Legacy Mount Hood Medical form.
To fill out Legacy Mount Hood Medical, you need to provide accurate information about your medical history, current health status, and any treatments or medications you are receiving.
The purpose of Legacy Mount Hood Medical is to ensure that healthcare providers have access to essential medical information to provide appropriate care and treatment.
The information required on Legacy Mount Hood Medical includes personal details, medical history, current health status, medications, allergies, and emergency contacts.
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