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STATE OF NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH SERVICES THERAPEUTIC CANNABIS PROGRAM Lori A. Robinette Commissioner Patricia M. Villa Director29 HAVEN DRIVE,
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How to fill out minor patient application
How to fill out minor patient application
01
To fill out a minor patient application, follow these steps:
02
Open the minor patient application form.
03
Provide the patient's personal information, such as name, date of birth, and gender.
04
Fill out the parent or guardian's information, including their name, contact details, and relationship to the patient.
05
Include the patient's medical history, any known allergies, and current medications.
06
Provide insurance information if applicable.
07
Sign and date the application form.
08
Submit the completed application to the relevant healthcare provider.
Who needs minor patient application?
01
Minor patient application is needed by anyone who is under the age of 18 and requires medical treatment or services.
02
It is typically required by healthcare providers, doctors, hospitals, or clinics when providing care to a minor.
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What is minor patient application?
The minor patient application is a form used to request medical treatment for patients who are under the age of 18.
Who is required to file minor patient application?
Parents or legal guardians of minor patients are required to file the minor patient application.
How to fill out minor patient application?
The minor patient application can be filled out online or in person at the healthcare facility where the treatment is being sought. It requires basic information about the patient, their medical history, and the treatment needed.
What is the purpose of minor patient application?
The purpose of the minor patient application is to ensure that minor patients receive the medical treatment they need in a timely manner.
What information must be reported on minor patient application?
The minor patient application must include the patient's personal information, medical history, details of the treatment being sought, and contact information for the parent or legal guardian.
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