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My PRIMARY Hometown Pediatrician is to bear. Chandler Dr. Moored. John Dr. Smith Dr. HathawayHometown Pediatrics PATIENT INFORMATION (Please Print Clearly)Date of Birth:Patient Name: Ethnicity:HispanicNonHispanicRace:Sex:MaleFemaleLanguage

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How to fill out Hometown Pediatrics New Patient Packet for Non-Newborns

1. Start by downloading or obtaining the Hometown Pediatrics New Patient Packet for Non-Newborns.
2. Review the cover page which provides an overview of the packet's purpose.
3. Fill out the personal information section with the child's full name, date of birth, and address.
4. Provide the parent's or guardian's information, including their name, contact number, and relationship to the child.
5. Complete the medical history section by detailing any previous illnesses, surgeries, allergies, and current medications.
6. Include immunization records, ensuring to attach copies of any relevant documentation.
7. Specify any concerns or specific needs the child may have.
8. Sign and date the consent forms included in the packet.
9. Review all filled sections for accuracy and completeness.
10. Submit the completed packet in person or via the specified submission method provided by Hometown Pediatrics.

Who needs Hometown Pediatrics New Patient Packet for Non-Newborns?

1. Any child who is new to Hometown Pediatrics and requires medical attention other than newborns.
2. Parents or guardians seeking to establish care for their non-newborn children at Hometown Pediatrics.

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What is Hometown Pediatrics New Patient Packet for Non-Newborns?

The Hometown Pediatrics New Patient Packet for Non-Newborns is a collection of forms and information that new patients who are not newborns must complete before their first visit to the clinic.

Who is required to file Hometown Pediatrics New Patient Packet for Non-Newborns?

Any non-newborn patient wishing to establish care with Hometown Pediatrics is required to fill out the New Patient Packet.

How to fill out Hometown Pediatrics New Patient Packet for Non-Newborns?

To fill out the packet, patients should carefully read each form, provide accurate personal and medical information, and submit it to the clinic prior to their appointment.

What is the purpose of Hometown Pediatrics New Patient Packet for Non-Newborns?

The purpose of the packet is to gather essential information about the patient's medical history, insurance details, and other relevant data to ensure a comprehensive evaluation during their first appointment.

What information must be reported on Hometown Pediatrics New Patient Packet for Non-Newborns?

The packet typically requires personal information such as the patient's name, date of birth, contact information, medical history, current medications, allergies, and insurance details.