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Jamila Battle, M.D. 8300 Health Park, Suite 201 Raleigh, NC 27615 www.CarolinaPerformance.net 8883120127 ext. 1 New Client Intake Form for Dr. Jamila Battleaxe: Date: Mailing Address:Physical Address
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8300 Health Park Suite is the location/address of a specific establishment or facility.
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Individuals or entities who receive more than $10,000 in cash in one transaction or a series of related transactions are required to file Form 8300.
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Information such as the amount of cash received, the date of transaction, the identity of the person conducting the transaction, and the nature of the transaction must be reported on Form 8300.
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