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PATNFORM2005×reprint2008:PATNFORM2005.qxd9/10/20084:22 PM Page 1Commonwealth Medical Physician Group Patient InformationPLEASE PRINT / PLEASE FILL IN COMPLETELYPATIENT NAME ___ FIRST SEX M FLASTBIRTH

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What is mcphailcliniccom11patient-intake-form-1date marital status s?

mcphailcliniccom11patient-intake-form-1date marital status s is a section on the intake form where the patient is required to provide their marital status.

Who is required to file mcphailcliniccom11patient-intake-form-1date marital status s?

All patients visiting McPhail Clinic are required to fill out the mcphailcliniccom11patient-intake-form-1date, including the marital status section.

How to fill out mcphailcliniccom11patient-intake-form-1date marital status s?

To fill out the mcphailcliniccom11patient-intake-form-1date marital status s, the patient needs to indicate whether they are single, married, divorced, widowed, or in a domestic partnership.

What is the purpose of mcphailcliniccom11patient-intake-form-1date marital status s?

The purpose of collecting marital status information on the intake form is to have a better understanding of the patient's personal background and to provide appropriate medical care.

What information must be reported on mcphailcliniccom11patient-intake-form-1date marital status s?

The patient must report their current marital status, including whether they are single, married, divorced, widowed, or in a domestic partnership.

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