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Welcome To WEPT, LLC
Thank you for choosing What com Community Physical Therapy, LLC.
We look forward to helping you meet your rehabilitation needs.
To help us serve you more efficiently, please fall
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How to fill out new patient information form
How to fill out new patient information form
01
Obtain a new patient information form from the reception desk or download it from the clinic's website.
02
Start by providing your personal details such as your full name, date of birth, and contact information.
03
Fill in your medical history, including any existing conditions, allergies, or medications that you are currently taking.
04
Provide information about your insurance coverage, including your insurance provider and policy number.
05
Answer any specific health-related questions or concerns mentioned on the form.
06
If applicable, provide the contact details of your previous healthcare provider for records transfer.
07
Read through the terms and conditions section carefully before signing and dating the form.
08
Return the completed form to the reception desk or submit it as instructed.
09
Keep a copy of the filled out form for your reference.
Who needs new patient information form?
01
New patients visiting a healthcare facility or clinic for the first time.
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What is new patient information form?
New patient information form is a document where new patients provide their personal and medical information to healthcare providers.
Who is required to file new patient information form?
New patients who are seeking medical treatment or services are required to file the new patient information form.
How to fill out new patient information form?
To fill out the new patient information form, patients need to provide their name, contact information, medical history, insurance details, and any other relevant details requested by the healthcare provider.
What is the purpose of new patient information form?
The purpose of the new patient information form is to gather essential information about the patient to provide them with appropriate medical care and treatment.
What information must be reported on new patient information form?
The new patient information form typically requires information such as patient's personal details, medical history, current health conditions, insurance information, and emergency contacts.
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