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Drexel Hill Pediatric Associates REGISTRATION FORM Page 1Patient Name: DOB: / / Race: Language: Ethnicity: Mothers Information Full Name: Date of Birth: / / SS #: Primary Phone # (1): Primary Phone
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Start by obtaining the necessary forms from Drexel Hill Pediatric Associates.
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Fill in your personal information such as name, address, and contact details.
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Provide information about the child including their name, date of birth, and any medical conditions or allergies.
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List any medications the child is currently taking.
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Specify if there are any specific healthcare providers or specialists the child is seeing.
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Drexel Hill Pediatric Associates is needed by parents or guardians who have children in need of medical care or regular check-ups.
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Drexel Hill Pediatric Associates is a healthcare provider specializing in pediatric care.
Drexel Hill Pediatric Associates is required to file their financial information and tax returns.
Drexel Hill Pediatric Associates must fill out their financial information accurately and completely.
The purpose of Drexel Hill Pediatric Associates is to provide quality healthcare services to children.
Drexel Hill Pediatric Associates must report their revenue, expenses, and any other financial information.
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