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Physician Referral Form Toll Free Phone: 1 (888) 282 7763 / Toll Free Fax: 1 (844) 320 9652Patient Information: Name: ___Date of Birth: ___Health Card #___ (MM/DD/YYY)Address:___City: ___Postal Code:___
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What is wwwcarecentrixcomccfaqhow-does-my-physicianhow does my physician?
The physician is responsible for providing medical services to patients.
Who is required to file wwwcarecentrixcomccfaqhow-does-my-physicianhow does my physician?
Physicians are required to file their physician services.
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Physicians can fill out the physician services form online or by submitting a paper form.
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The purpose of the physician services form is to document the medical services provided by the physician.
What information must be reported on wwwcarecentrixcomccfaqhow-does-my-physicianhow does my physician?
Physicians must report details of the services provided, patient information, and billing information.
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