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4202 Del Prado Blvd. S Cape Coral, FL 33904 P: 239.540.9918 F:239.540.9921 www.DrTereseTaylor.comPATIENT INTAKE Format: Gender’M / PATIENT NAME : Age: Date of Birth: / / PREFERRED CONTACT METHOD:
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Proceed to fill out the sections related to your medical history, including any pre-existing conditions, medications, and allergies.
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Answer the questions regarding your symptoms, duration, and severity of the current issue you are seeking medical assistance for.
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Aim Patient Intake 1docx is a document used to collect patient information and evaluate their eligibility for specific services or programs.
Healthcare providers, administrative staff, or authorized representatives are typically required to file the Aim Patient Intake 1docx.
To fill out Aim Patient Intake 1docx, provide accurate patient details, medical history, and other required information as specified in the document's sections.
The purpose of Aim Patient Intake 1docx is to gather essential data for patient assessment, aid in treatment planning, and ensure compliance with healthcare regulations.
Information that must be reported includes patient demographics, medical history, current health status, and any previous treatments or medications.
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