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CITIZENS MEDICAL CENTER, INC. 100 E COLLEGE DR. COLBY, KS 67701 PH: (785) 4601260 FAX: (785) 4601261 cmc_lab@cmciks.comDIRECT ACCESS TESTING REQUISITION NAME:DATE:ADDRESS:Account #CITY, STATE, ZIP:
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To fill out a physical therapy citizen's medical form, follow these steps:
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Begin by providing personal information such as your name, date of birth, and contact information.
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Next, fill in your medical history, including any pre-existing conditions, surgeries, or major illnesses.
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Include information about any current medications you may be taking, including dosage and frequency.
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Specify the reason for seeking physical therapy and any specific areas or concerns you would like to address.
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If you have any previous physical therapy records or imaging reports, mention them and attach copies if necessary.
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Provide insurance details, including your policy number and contact information for verification purposes.
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Finally, review the form for completeness and accuracy before submitting it to the physical therapy clinic.
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Remember, it's important to provide accurate and honest information to ensure appropriate and effective treatment.

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Doctors, specialists, and physical therapists may request these forms to assess a patient's medical history and determine appropriate treatment plans.
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It is advisable to consult with a healthcare professional to confirm if you need to fill out such a form.
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Physical formrapy citizens medical is a form that documents the medical history and current health status of citizens.
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Physical formrapy citizens medical can be filled out by providing personal information, medical history, and current health status.
The purpose of physical formrapy citizens medical is to ensure that citizens receive appropriate medical care and support based on their health status.
Information such as personal details, medical history, current health status, and any specific medical conditions must be reported on physical formrapy citizens medical.
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