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DR. MOSCOW & ASSOCIATES PATIENT INFORMATION Name Sex:MaleFemaleDate / / Date of Birth Age Cell Phone () Home () Work () Email address Preferred Method of contact Social Security # Address City State
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01
Start by gathering all necessary information such as the patient's personal details including name, address, contact number, and date of birth.
02
Include a detailed description of the auto accident, including the date, time, and location of the incident.
03
Document any injuries sustained by the patient during the accident, including visible wounds or signs of trauma.
04
Include a description of any immediate medical treatment received by the patient following the accident.
05
Ask the patient about any pre-existing medical conditions or previous injuries that may be relevant to the accident.
06
Include a list of any medications currently being taken by the patient.
07
Document any symptoms or complaints mentioned by the patient, even if they seem unrelated to the accident.
08
Ask the patient about their insurance information, including the name of the insurance company and policy number.
09
Make sure to obtain the patient's signature and date on the history form to acknowledge the accuracy of the provided information.
10
Review the completed patient history-auto accidentdoc form for any missing or inconsistent information before filing it in the patient's medical records.

Who needs patient history-auto accidentdoc?

01
Patient history-auto accidentdoc is needed by healthcare providers, specifically those involved in treating patients who have been in auto accidents.
02
Insurance companies may also require this document when assessing claims related to auto accidents.
03
Legal professionals, such as attorneys representing clients involved in auto accidents, may also need access to the patient history-auto accidentdoc.
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Patient history-auto accidentdoc is a document that records any relevant medical history related to auto accidents.
Patients who have been involved in auto accidents are required to fill out and file patient history-auto accidentdoc.
Patients need to provide detailed information about any auto accidents they have been involved in, including the date, location, and any injuries sustained.
The purpose of patient history-auto accidentdoc is to help healthcare providers understand the medical history of patients who have been in auto accidents and provide appropriate treatment.
Patients must report details of the auto accident, any injuries sustained, any medical treatment received, and any ongoing symptoms.
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