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DEBT of Southern Oregon IInntteeggrraatteedd H Heeaalltthh SSeerrvviicceess, IIN NC CPH: pH: (541) (541) 6210303 6210303 Fax:541Fax:5417086557 7086557CLIENT INFORMATION Today's Date: Client Name Date
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Information that must be reported includes patient demographics, types of services provided, outcomes of care, and any relevant health statistics related to women's health.
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