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Medical Record # ___ Place patient label here8401 Medical Plaza Drive, Suite 300, Charlotte NC 28262 PHONE: (704) 316 6561 Faxes: (704) 3841974AUTHORIZATION TO DISCLOSE HEALTH INFORMATION Authorization
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01
Visit the Charlotte Community Health Clinic website or contact them directly to inquire about their patient registration process.
02
Provide the necessary personal information such as name, address, date of birth, and insurance information.
03
Schedule an appointment to meet with a healthcare provider at the clinic.
04
Attend the appointment and follow any instructions given by the healthcare provider.
05
Fill out any forms or questionnaires provided by the clinic accurately and completely.
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Be sure to ask any questions or concerns you may have during your visit to the clinic.

Who needs charlotte community health clinic?

01
Individuals who do not have health insurance and are in need of affordable healthcare services.
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Low-income individuals and families who are seeking medical assistance.
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Residents of the Charlotte area who require primary care services but may not have access to a regular healthcare provider.
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Charlotte Community Health Clinic is a non-profit organization that provides medical services to underserved communities in Charlotte.
Charlotte Community Health Clinic is typically required to file annual reports with relevant government agencies.
To fill out Charlotte Community Health Clinic reports, you will need to provide information on services provided, financial data, and demographics of patients served.
The purpose of Charlotte Community Health Clinic is to provide affordable healthcare services to those in need.
Information such as patient demographics, services provided, financial data, and any community outreach programs must be reported on Charlotte Community Health Clinic reports.
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