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IVG NEUROLOGY REFERRAL FORM tel: 8004966111Todays Date CURRENT PATIENT NEW PATIENT FAX: 8005401852July 2016Patient Name ___ SS#___ DOB ___ Height ___ Weight ___ Address ___ Apt # ___ Male Felicity
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Neurological disorders relate to conditions affecting the brain, spinal cord, and nerves. Intravenous refers to delivering medication or fluids through a vein.
Healthcare practitioners and facilities may be required to report neurological disorders and intravenous treatments.
Neurological disorders and intravenous treatments are typically documented by healthcare professionals in medical records.
The purpose is to track and monitor the diagnosis and treatment of neurological disorders and intravenous interventions.
Information such as patient's medical history, symptoms, diagnostic tests, treatment plans, and outcomes may be reported.
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