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OSU Dental Clinics Patient Referral Information Please fill out all fields. Any missing information can delay the referral process. Date: Patient Name: Date of Birth: Male Female Preferred Phone:
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To fill out the OHSU Dental Clinics form, follow these steps:
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Visit the OHSU Dental Clinics website
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Click on the 'Forms' tab or navigate to the specific form you need to fill out
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Submit the filled-out form to OHSU Dental Clinics through the specified submission method (online upload, email, fax, or in-person)
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OHSU Dental Clinics serve a wide range of individuals who require dental care, including:
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OHSU Dental Clinics are dental care facilities affiliated with Oregon Health & Science University.
The individuals or entities providing dental services through OHSU Dental Clinics are required to file.
OHSU Dental Clinics forms can be filled out online or in person at the clinics.
The purpose of OHSU Dental Clinics is to provide high-quality dental care to patients and to train future dental professionals.
Information such as patient demographics, services provided, and billing details must be reported on OHSU Dental Clinics forms.
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