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NEW PATIENT REFERRAL FORM Scheduling Line: 8653312060 Electronic Fax: 8653742083 DATE:Is this referral urgent?YES NO Is the patient aware of this referral? YES NO May we contact and notify this patient?
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What is is form patient aware?
The is form patient aware is a document used to report patient's awareness of their treatment and care.
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Healthcare providers and facilities are required to file the is form patient aware.
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The is form patient aware can be filled out by documenting the patient's acknowledgement of their treatment plan and discussing it with them.
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The purpose of is form patient aware is to ensure that patients are informed and aware of their treatment plans and options.
What information must be reported on is form patient aware?
Information such as the patient's understanding of the treatment, any concerns or questions they may have, and the patient's signature acknowledging their awareness.
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