Get the free New Patient information - Van Gordon Dentistry

Brock A. Van Gordon, DMD, P.C. Family & Cosmetic Dentistry 30045 SW Parkway Avenue Wilsonville, OR 97070 Patient Information (This information is necessary for our files and will be considered CONFIDENTIAL)

How to fill out new patient information

How to fill out new patient information:

1. Start by entering your personal details such as your full name, date of birth, and gender. It's important to provide accurate information to ensure proper identification and effective communication.
2. Next, include your contact information such as your address, phone number, and email address. This will enable the healthcare provider to reach out to you for any necessary follow-ups or updates.
3. Provide your insurance information, including your policy number and group number, if applicable. This data helps the medical facility process your insurance claims and ensures proper billing.
4. Indicate any known medical conditions or allergies that you have. This information is crucial for healthcare professionals to understand your medical history and provide appropriate care.
5. List any medications you are currently taking, including the dosage and frequency. This assists the healthcare provider in assessing potential drug interactions and providing suitable treatment options.
6. Include emergency contact details, such as the name, phone number, and relationship of someone who should be contacted in case of any medical emergencies.
7. Lastly, carefully read and sign the consent forms, acknowledging your understanding of the facility's policies, procedures, and privacy practices.

Who needs new patient information:

1. Patients who are visiting a healthcare facility for the first time need to fill out new patient information. This could be for various healthcare services, including primary care, specialists, or hospitals.
2. Individuals who have recently moved and are seeking medical care from a new healthcare provider would also need to provide new patient information.
3. Patients who have not visited a healthcare facility for an extended period might also be required to update their information to ensure accuracy and provide the most up-to-date medical history.

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What is new patient information?

New patient information includes details such as patient's personal information, medical history, insurance information, and contact details.

Who is required to file new patient information?

Healthcare providers, hospitals, and clinics are required to file new patient information.

How to fill out new patient information?

New patient information can be filled out by the patient themselves or by a healthcare provider during the registration process.

What is the purpose of new patient information?

The purpose of new patient information is to maintain accurate medical records and provide quality care to patients.

What information must be reported on new patient information?

Information such as patient's name, date of birth, address, medical history, insurance details, and emergency contacts must be reported on new patient information.