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PATIENT INFORMATION (CONFIDENTIAL) NameDateAddressCityEmailStateCell phones#BirthdateZipHome phone Circle one:SingleMarriedOtherEmployer Work phone Emergency contact: Phone How/where did you learn
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Our practice-family is a structured approach to managing family-related matters and resources, focusing on shared values, goals, and responsibilities.
Typically, all adult family members who are involved in the practice-family or benefit from it are required to file.
To fill out our practice-family, gather necessary documentation and information, complete the designated forms, and ensure all sections are accurately filled before submission.
The purpose of our practice-family is to ensure that family members are aligned in their goals, responsibilities, and support systems to enhance family cohesion and well-being.
Information that must be reported includes family members' names, roles, contributions, and any agreements or commitments made within the family structure.
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