
Get the free Australian Government Directory of Services for Older People
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RECHECK AND DIABETES MEDSCHECKINITIAL PATIENT REGISTRATION INTERVIEW FORM
Patient Details
Patient Medicare/DVA number:
Patient Date of Birth:
Patient Gender:Male
Female
Intersex or indeterminate
Otherwise
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To fill out the Australian Government Directory, follow these steps:
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Contact information such as names, positions, phone numbers, and email addresses must be reported on the Australian government directory.
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