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TENNESSEE NEUROLOGY SPECIALISTS AT SAINT THOMAS WEST HOSPITAL Michael J. Kaminski, M.D. Robert J. Falls, M.D. Oscar E. Mendez, M.D. E. Frank La franchise, M.D. Receive C. Lisbon, M.D. Roxanne M. Valentino,
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How to fill out Saint Thomas Neurology Group:

01
Start by gathering all necessary information: Make sure you have your personal details, medical history, and any relevant documents ready before you begin filling out the form.
02
Access the form: Visit the Saint Thomas Neurology Group's website or contact them directly to obtain the form. It may be available for download or as an online form.
03
Personal Information: Begin by entering your full name, date of birth, gender, and contact information. Include your address, phone number, and email address.
04
Insurance Information: Provide details about your health insurance provider, policy number, and any other relevant insurance information. If you have multiple insurance plans, indicate the primary one.
05
Medical History: Fill in your medical history, including any past surgeries, diagnoses, or ongoing medical conditions. Include details of any neurological issues or symptoms you are experiencing.
06
Medications: List any current medications you are taking, including both prescription and over-the-counter drugs. Include the dosage and frequency of each medication.
07
Allergies: Note any allergies or adverse reactions you have had to medications, foods, or other substances.
08
Referring Physician: If applicable, provide the name and contact information of the physician or healthcare professional who referred you to the Saint Thomas Neurology Group.
09
Reason for Visit: Explain the reason for seeking neurology services. Describe the symptoms or concerns you are experiencing and any specific areas of your neurological health you would like assessed.
10
Consent and Signature: Review the form, ensure all information is accurate, and sign the document. By signing, you authorize the Saint Thomas Neurology Group to access your medical records, communicate with your other healthcare providers, and provide you with medical services.

Who needs Saint Thomas Neurology Group:

01
Individuals experiencing neurological symptoms: People who are experiencing symptoms such as persistent headaches, numbness or tingling, memory problems, dizziness, seizures, or any other concerning neurological issues may benefit from seeking the expertise of the Saint Thomas Neurology Group.
02
Those with diagnosed neurological conditions: Individuals already diagnosed with neurological disorders such as epilepsy, multiple sclerosis, Parkinson's disease, or stroke may require ongoing care and management from a specialized neurology group like Saint Thomas.
03
Referrals from other healthcare professionals: Physicians, primary care doctors, or other healthcare providers may refer patients to the Saint Thomas Neurology Group for a comprehensive evaluation or specialized treatment related to neurological conditions.
04
Individuals seeking a second opinion: Patients who wish to seek a second opinion regarding a neurological diagnosis or treatment plan can benefit from consulting the experts at the Saint Thomas Neurology Group.
05
Anyone looking for specialized neurological care: Individuals who prioritize specialized care and expertise in the field of neurology may choose the Saint Thomas Neurology Group as their preferred healthcare provider.
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Saint Thomas Neurology Group is a medical practice specializing in neurology.
Patients who receive services from Saint Thomas Neurology Group may be required to file certain forms or reports.
Patients can fill out forms or reports related to Saint Thomas Neurology Group either online or at their office.
The purpose of Saint Thomas Neurology Group is to provide neurological care and treatment to patients.
Information such as medical history, symptoms, and treatment plans may need to be reported on forms related to Saint Thomas Neurology Group.
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