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2625 Shad elands Drive
Walnut Creek, CA 94598
(925) 9398585
Participation Physical Evaluation (Page 1 of 2)
Part 1. Student Information (The parent or guardian should fill out this form with assistance
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How to fill out muir orthopaedic specialists patient
How to fill out muir orthopaedic specialists patient
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To fill out Muir Orthopaedic Specialists patient forms, follow these steps:
02
Start by downloading the patient forms from the official Muir Orthopaedic Specialists website.
03
Open the downloaded forms on your computer or print them out.
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Read the instructions provided carefully and fill out the requested information accurately.
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Make sure to fill in all the required fields, marked with asterisks or specified in the instructions.
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Provide your personal details such as name, address, contact information, and date of birth.
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If applicable, provide your insurance information, policy number, and primary care physician details.
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Complete any medical history sections, including past surgeries, current medications, and known allergies.
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If you have a specific issue or concern, provide a detailed description of your symptoms.
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Sign and date the forms where required.
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Double-check your filled forms for any errors or missing information.
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Submit the completed forms to Muir Orthopaedic Specialists as instructed, either by mailing them or bringing them to your appointment.
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Note: It's always a good idea to call Muir Orthopaedic Specialists if you have any questions or need assistance with filling out the patient forms.
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- Individuals in need of joint replacement surgeries
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Muir Orthopaedic Specialists provides comprehensive orthopaedic services for people of all ages and activity levels.
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