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TO OUR PATIENTS: Please bring this form with you for your appointment. Please notify us if you are unable to keep your appointment. Northern CaliforniaRetina Vitreous Assoc. Medical Group, Inc. Sterling
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Gather all necessary personal information such as name, address, and contact details.
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Begin by filling out the patient's basic details, including date of birth and gender.
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Move on to medical history, by asking about any existing conditions, allergies, or previous surgeries.
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Record the patient's current medications, including dosage and frequency.
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Our patients include individuals of all age groups who require medical care or treatment.
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This includes individuals with acute or chronic illnesses, those in need of regular check-ups, or those seeking preventive care.
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Our patients may also be individuals who require specialized medical services or consultations.
04
Anyone who seeks medical attention from our healthcare facility can be categorized as our patient.
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To provide quality care and ensure patient satisfaction.
Healthcare providers and facilities.
By accurately documenting patient information and treatment provided.
To keep patients informed about their healthcare and facilitate communication.
Diagnosis, treatment plan, medications, follow-up instructions.
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