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*8460124692* LINEUPPATIENTI. D. LABELHEREABOUT FINANCIAL ARRANGEMENTS AND MEDICAL INSURANCE Estimate of Benefits and Patient ResponsibilityALTAMONTE / DOWNTOWN ORLANDO / SPRING LAKE / OCOEE / Sanford
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Provide your medical history, including any previous diagnoses, treatments, and medications.
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Form 8460-124692 at Orlando Health (orlandohealth.com) is needed by individuals who require medical services at Orlando Health. This form may be necessary for new patients, existing patients seeking additional services, or individuals visiting specific departments or clinics within Orlando Health. It helps Orlando Health collect necessary information for patient records, insurance billing, and providing appropriate medical care. It is important to consult with Orlando Health or follow their guidelines to determine if this form is specifically required for your situation.
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