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Libyan Wellness Center 100 West Old Carlton Pike Carlton, NJ 08053 Date: Patients Name: Chief Complaint: Address: Home Phone: Cell Phone: Social Security #: Email: Date of Birth: Age: Marital Status:
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Confidential Patient Information Document (CPID) is a formal record that collects sensitive patient data that must be handled with strict confidentiality.
Healthcare providers, hospitals, and institutions that handle patient data are required to file the Confidential Patient Information Document.
To fill out the CPID, you must accurately enter the patient's information, ensure the confidentiality of their data, and follow any specific formatting or documentation guidelines provided by regulatory bodies.
The purpose of the CPID is to ensure that patient information is collected, managed, and protected in compliance with privacy laws and regulations.
The CPID typically requires personal details such as the patient's name, identification number, contact information, medical history, and any other relevant health data.
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