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PATIENTACQUAINTANCEFORMDate Whom may we thank for referring you to our office? Name Nickname Date of Birth Mrs. Ms. Mr. Dr. Male FemaleDENTALHISTORYWhen was your last dental visit? When was your last
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P a t i stands for Patient Assessment and Taxpayer Identification.
Healthcare providers are required to file p a t i for each patient.
P a t i can be filled out online through the designated government portal.
The purpose of p a t i is to assess the patient's condition and verify their taxpayer identification.
Information such as the patient's name, address, medical history, and taxpayer identification must be reported on p a t i.
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