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HEADER HEREPATIENT ID HEREON DENSITOMETRY REQUISITION (BMD) Referring Physician Name (please print): Signature: Date: / / Billing number: Tel: Fax: YYY / MM / DD BASELINE Patients with any of the
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BMD - seniors health is a form for reporting health information of senior citizens.
Healthcare providers and facilities providing services to senior citizens are required to file BMD - seniors health.
BMD - seniors health form can be filled out online or submitted in person at the designated office.
The purpose of BMD - seniors health is to track and monitor the health status of senior citizens for research and policy-making purposes.
Information such as medical history, current medications, and any existing health conditions of senior citizens must be reported on BMD - seniors health.
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