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PATIENT REGISTRATION FORM Last name:First name:Middle Initial:Pt #:Mailing address:Age:Gender:City, State, Zip:Date of Birth:Physical address (if different from mailing address):Cell #:Name of Physician
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How to fill out physical address if different

01
To fill out a physical address if different, follow these steps:
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Start by entering your full name in the appropriate field.
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Then, provide your primary contact number for any queries related to your address.
04
Next, enter your current mailing address or primary contact address.
05
If your physical address is different from the above mentioned, check the 'Different Physical Address' box.
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Once checked, a new set of fields will appear asking for your physical address details.
07
Provide the complete physical address including the street name, building number, apartment or suite number, city, state, ZIP or postal code, and country.
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Ensure to double-check the accuracy of the provided address before submitting the form.
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Lastly, click on the 'Submit' button to complete the address form.
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Note: Make sure to fill out the physical address accurately as it may be required for verification purposes.

Who needs physical address if different?

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There are several instances where providing a different physical address may be necessary. Some examples include:
02
- Students studying abroad who have a temporary residential address in another country.
03
- Remote employees or freelancers who work from home but have a corporate mailing address.
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- Individuals who have a permanent residence in one location but frequently travel or stay at a secondary address.
05
- People who have multiple properties and need to specify a different address for each.
06
- Businesses that have a separate mailing address and a physical location for their operations.
07
In such cases, it is vital to accurately provide the different physical address to ensure proper communication and delivery of important documents.
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The physical address if different is an alternate address provided by an individual or business that is different from their mailing address.
Individuals or businesses who have a different physical address than their mailing address are required to file the physical address if different.
To fill out the physical address if different, individuals or businesses can usually do so on official forms provided by government agencies or online platforms.
The purpose of the physical address if different is to ensure that important correspondence or documents can be sent to the correct location, especially if the mailing address is not suitable for receiving mail.
The physical address if different typically requires the reporting of the alternate address where mail or packages should be sent.
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