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Patients Name: ___ DOB: ___FINANCIAL POLICY Thank you for choosing Mundelein Pediatrics, S.C. (MP) as your children healthcare provider. We are committed to provide your Child (men) with the best
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New patients refer to individuals who are visiting a healthcare provider for the first time and require an initial assessment and registration.
Healthcare providers and practices that accept new patients are required to file and maintain documentation for these individuals.
To fill out new patient forms, individuals typically need to provide personal information, medical history, insurance details, and contact information.
The purpose is to gather essential information for proper care, establish a patient-provider relationship, and ensure accurate medical records.
Information to be reported includes the patient's demographic details, medical history, current medications, allergies, and insurance coverage.
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