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Medical Information Release BURLINGTON PEDIATRICS P.A. 530 West Webb Avenue Burlington, NC 27217 Telephone: (336) 228-8316 Facsimile: (336) 227-9750 Pediatric and Adolescent Medicine Consent for Release
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Begin by visiting the Burlington Pediatrics West website or office to obtain the necessary forms.
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Fill out personal information, including name, address, phone number, and insurance information, on the patient registration form.
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Provide relevant medical history, including any previous illnesses, surgeries, or allergies.
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Indicate the primary care provider (if any) and list any medications currently being taken.
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Fill out additional forms as required, such as consent forms or specialized questionnaires.
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Submit the filled-out forms either in person or through the designated online portal.

Who needs Burlington Pediatrics West:

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Infants, children, and adolescents who are in need of medical care and support.
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Parents or guardians seeking a trustworthy and reliable pediatric healthcare provider for their child.
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Individuals searching for comprehensive pediatric services, including routine check-ups, vaccinations, and specialized care for various medical conditions or concerns.
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Burlington Pediatrics West is a pediatric healthcare facility located in the Burlington area.
Parents or legal guardians of children who receive care at Burlington Pediatrics West are required to file necessary paperwork.
To fill out Burlington Pediatrics West paperwork, parents or legal guardians must provide accurate information about the child's medical history, insurance coverage, and contact details.
The purpose of Burlington Pediatrics West is to provide medical care and treatment to children in the community.
Information such as the child's medical history, current health concerns, insurance information, and emergency contact details must be reported on Burlington Pediatrics West forms.
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