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MT. AIRY FOOT & ANKLE CENTER DR. JAMES R. SHIRLEY, PM PATIENT INFORMATION FORM (PLEASE PRINT)DATE: / / PATIENT NAME: DATE OF BIRTH: / / AGE: SEX: M F LASTFIRSTMIMARITAL STATUS: SINGLE MARRIED PARTNERED
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Airy Foot & Ankle is a medical practice focusing on the diagnosis and treatment of foot and ankle conditions, providing specialized care for various ailments related to those areas.
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Patients seeking treatment from Airy Foot & Ankle generally do not file anything; however, healthcare providers may need to submit specific forms or insurance claims for reimbursement.
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To fill out the required paperwork for Airy Foot & Ankle, patients should accurately complete any medical history forms, insurance information, and consent forms as directed by the staff during their visit.
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The purpose of Airy Foot & Ankle is to provide comprehensive care and treatment options for patients suffering from foot and ankle disorders, enhancing mobility and quality of life.
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Information typically required includes personal identification details, medical history, any current medications, and specific symptoms related to foot or ankle issues.
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