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WILLIAM EARL FOX, M.D. 675 Peter Jefferson Parkway Suite 335 Charlottesville, VA 22911CREDIT CARD ON FILE AUTHORIZATION FORM Patients Legal Birth Name: Patients D.O.B.: Card Type (circle one): VISAMASTERCARDDISCOVERAMERICAN
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What is patient forms - dr?
Patient forms - dr are documents that gather necessary information about the patient's medical history, insurance information, and contact details.
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Patients are required to fill out and file patient forms - dr prior to their appointment with the doctor.
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