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Get the free NC BREAST AND CERVICAL CANCERCONTROL ... - bcccp.ncdhhs.gov

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NC BREAST AND CERVICAL CANCER CONTROL PROGRAM (NC CCCP) PATIENT NAVIGATIONAL FORM FAX to (919) 8704812 Patient ID: NC CCCP Provider Code: First Contact Date: (MM DD YYY) / / Client DemographicsType
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To fill out the NC Breast and Cervical form, follow these steps:
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Obtain the form from the official website or local health department.
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Provide accurate personal information such as name, address, and contact details.
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The NC Breast and Cervical form is typically needed by individuals who are seeking breast and cervical screening services in the state of North Carolina. This form is used to gather relevant information about the individual's medical history and insurance coverage to ensure proper screening and follow-up care.
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NC Breast and Cervical Cancer Control Program is a program that provides free or low-cost breast and cervical cancer screenings and follow-up services to eligible women in North Carolina.
Healthcare providers participating in the program are required to file the necessary documentation for each patient.
Healthcare providers need to complete the required forms and submit them along with the necessary medical information for each patient.
The purpose of the program is to increase access to early detection and treatment of breast and cervical cancer for eligible women.
Healthcare providers must report patient demographic information, screening results, and any follow-up services provided.
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