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ADC/LAKESIDE MEDICAL ORGANIZATION/ REGAL MEDICAL GROUP Case Management Referral Form Patient Name: DOB: Family/Caregiver (Name and Phone): Completed by: PCP: Date: Case Management Referral Criteria:
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Regal Medical Group Lakeside Medical is a healthcare provider network that offers medical services to individuals in a certain region.
Healthcare providers who are part of the Regal Medical Group Lakeside Medical network are required to file.
To fill out Regal Medical Group Lakeside Medical forms, providers must include all required patient and billing information accurately.
The purpose of Regal Medical Group Lakeside Medical is to streamline healthcare services and ensure patients receive quality care.
Information such as patient demographics, medical history, treatment provided, and billing details must be reported on Regal Medical Group Lakeside Medical forms.
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