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INFORMATION LETTER FOR THE PATIENT (Version n. 1 14/06/2021)Title of the study: ASCAP An Innovative Smart Clinic for AF Patients Nonprofit observational study on the role of the community pharmacist
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The form is a patient registration form for Hendricks Regional Health.
All patients seeking medical services at Hendricks Regional Health are required to fill out the form.
Patients can fill out the form online or at the registration desk at Hendricks Regional Health.
The purpose of the form is to collect patient information necessary for medical treatment and billing purposes.
Patient's personal information, insurance details, medical history, and emergency contact information must be reported on the form.
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