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Confidential10201 W Innovation Drive Wauwatosa WI 53226 (800) 9630035 Fax: (608) 2453844 www.mychoicewi.org.provider Update Form Please note this is not a credentialing application. If credentialing

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How to fill out contact info for healthcare

01

Start by filling out your full name, including first name and last name.

02

Next, provide your contact information such as phone number and email address.

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Include your home address, including street address, city, state, and zip code.

04

If applicable, provide emergency contact information in case of medical emergencies.

05

Double check all the information for accuracy before submitting.

Who needs contact info for healthcare?

01

Patients seeking medical treatment

02

Healthcare providers for patient record keeping

03

Insurance companies for processing claims

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What is contact info for healthcare?

Contact info for healthcare is the information provided by individuals or organizations to enable communication with healthcare providers.

Who is required to file contact info for healthcare?

Individuals and organizations receiving healthcare services are required to file contact info for healthcare.

How to fill out contact info for healthcare?

Contact info for healthcare can be filled out by providing accurate and up-to-date contact details including name, address, phone number, and email.

What is the purpose of contact info for healthcare?

The purpose of contact info for healthcare is to ensure that healthcare providers can communicate effectively with patients or clients about their medical treatment and other health-related matters.

What information must be reported on contact info for healthcare?

Contact info for healthcare must include personal identification information such as name, date of birth, address, phone number, and email address.

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