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. 1411 St. Charles St. Houma, LA 70360 pH. 9857090136 Fax 9857090527 www.CoastalUC.com Please NOTIFY STAFF if you have an emergency such as: CHEST PAIN, a HEAD INJURY, SHORTNESS OF BREATH, SEVERE
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To fill out Coastal Urgent Care of, follow these steps:
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Visit the Coastal Urgent Care website or go to their physical location.
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Fill out the patient information form with your personal details like name, address, contact information, and insurance details.
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Provide details about your medical history, current symptoms, and any allergies or medications you are taking.
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If you have a specific reason for the visit, mention it in the provided space.
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Review the form for accuracy and completeness.
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Sign the form electronically or in-person depending on the submission method.
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Submit the form to a staff member at Coastal Urgent Care or follow the online submission process if applicable.

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Coastal Urgent Care of is for anyone who requires urgent medical attention but does not have a life-threatening emergency.
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Examples of individuals who may need Coastal Urgent Care include:
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- Individuals with minor injuries such as cuts, burns, sprains, or fractures.
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- Individuals who need minor diagnostic tests or X-rays.
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- Those needing vaccinations or routine medical check-ups.
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- Patients seeking immediate medical attention outside regular office hours or when their primary care doctor is unavailable.
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If you are unsure whether you need urgent care or emergency care, it is best to contact a healthcare professional for guidance.
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Coastal urgent care is a type of medical facility that provides immediate medical attention for non-life-threatening issues.
The medical staff and administrators of coastal urgent care facilities are required to file coastal urgent care of.
Coastal urgent care forms can be filled out electronically or on paper, with detailed information about the patient's condition and treatment.
The purpose of coastal urgent care of is to document the treatment provided to patients at urgent care facilities for record-keeping and quality assurance purposes.
Information such as patient demographics, presenting symptoms, treatment provided, and follow-up instructions must be reported on coastal urgent care of.
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