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TH6450 FOLSOM DRIVE BEAUMONT, TX 77706 pH. 4099231266 Fax 40992312768525 9 AVENUE PORT ARTHUR, TX 77642 pH. 4099231211 Fax 4093449256WORKERS COMP REGISTRATION FORM Date: PATIENT Name: Date of Injury:
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Beaumont Family Practice Associates is a healthcare provider that offers family medical services, including preventive care, chronic disease management, and wellness services to patients of all ages.
Typically, individuals and entities that receive care or services from Beaumont Family Practice Associates may need to file certain insurance or medical claims documentation. Additionally, healthcare providers affiliated with Beaumont may have specific requirements to file credentials or operating documentation.
To fill out forms for Beaumont Family Practice Associates, patients should provide accurate personal information, insurance details, medical history, and any relevant consent forms as requested. It is advisable to review any instructions provided by the practice.
The purpose of Beaumont Family Practice Associates is to provide comprehensive primary care services to families, promote health and wellness, manage acute and chronic illnesses, and ensure continuity of care within the community.
Information that must be reported typically includes patient demographics, insurance information, medical history, treatment plans, and notes on visits. Specific information may vary based on the forms being filled out and the services provided.
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