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Iowa Radiology 2018 Due to changes in the United States Health Care Reform, we are now required to obtain additional information at the time of service. PATIENT INFORMATION Patient Name: Date of Birth:
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The Iowa Radiology Patient Registration is a form that collects demographic and medical information from patients receiving radiology services.
Any patient receiving radiology services in Iowa is required to fill out the patient registration form.
Patients can fill out the Iowa Radiology Patient Registration form by providing their personal information, medical history, and insurance details.
The purpose of the Iowa Radiology Patient Registration is to collect necessary information for the radiology department to provide accurate and efficient services to patients.
The Iowa Radiology Patient Registration form typically includes fields for patient's name, date of birth, contact information, medical history, insurance details, and reason for visit.
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