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Danielle Morgan, MD, FLAP Ryan Muddy, MD, FLAP 7814 E 121st St Bixby, OK 74008 T: 9189435777 F:9186210505PLEASE PRINT & Fill Out Completely 1 Patient Information Full Name:___5 Secondary Insurance
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Start by providing the patient's personal information such as name, date of birth, and contact details.
02
Fill out the medical history section by including information about past medical conditions, allergies, and medications.
03
Document the present illness or reason for the visit in detail.
04
Record any diagnostic tests or procedures that have been done or are scheduled to be done.
05
Write down any treatments or medications prescribed during the visit.
06
Include any follow-up instructions or recommendations given by the healthcare provider.

Who needs premier pediatric and adolescent?

01
Premier pediatric and adolescent services are intended for children and young adults up to the age of 21.
02
Parents or guardians seeking quality healthcare services for their children can benefit from premier pediatric and adolescent care.
03
Individuals looking for specialized medical care tailored to the needs of children and adolescents may also seek out premier pediatric and adolescent services.
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Premier Pediatric and Adolescent is a medical practice specializing in healthcare for children and adolescents.
Premier Pediatric and Adolescent must be filed by healthcare providers specializing in pediatric and adolescent medicine.
Premier Pediatric and Adolescent can be filled out online or through physical forms provided by the medical practice.
The purpose of Premier Pediatric and Adolescent is to track and report medical information for children and adolescents under the care of the healthcare provider.
Information such as patient's medical history, current medications, treatment plans, and any medical procedures must be reported on Premier Pediatric and Adolescent.
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