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BROOMFIELD PEDIATRICS & INTERNAL MEDICINE PATIENT INFORMATION PLEASE PRINT Preferred Phone # to call you Today s Date: Patient Name: Name at Hospital (for Newborns) Sex: Birthdate: Marital Status:
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Broomfield Pediatrics & Internal is a medical practice that provides care for both children and adults in Broomfield, Colorado.
The medical staff and administrators of Broomfield Pediatrics & Internal are required to file any necessary paperwork related to the practice.
To fill out paperwork for Broomfield Pediatrics & Internal, staff members must provide accurate and up-to-date information about patients, treatments, and billing.
The purpose of Broomfield Pediatrics & Internal is to provide comprehensive medical care for patients of all ages in the Broomfield area.
Information such as patient histories, diagnoses, treatments, and billing details must be accurately reported on paperwork for Broomfield Pediatrics & Internal.
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