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MARYLAND BOARD OF PHYSICIANS 4201 Patterson Avenue P.O. Box 2571 Baltimore, Maryland 212150095 Telephone: 4107644777 or 8004926836Initial Medical Licensure Supplemental Form MBP ILL 3 4/2018Side A

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How to fill out application for initial medical

01

Obtain the application form for initial medical from the relevant medical authority or healthcare provider.

02

Fill in all the required personal information such as name, date of birth, address, contact information, and any relevant medical history.

03

Provide any necessary supporting documents such as identification, insurance information, and medical records.

04

Double check all the information provided and make sure it is accurate and up to date.

05

Submit the completed application form along with any supporting documents to the designated authority or healthcare provider.

Who needs application for initial medical?

01

Individuals who are seeking to undergo a medical examination for the first time or individuals who require a medical assessment for a specific purpose such as employment, travel, or insurance may need to fill out an application for initial medical.

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What is application for initial medical?

Application for initial medical is a form used to apply for an initial medical examination.

Who is required to file application for initial medical?

Individuals who are applying for a medical examination for the first time are required to file an application for initial medical.

How to fill out application for initial medical?

To fill out the application for initial medical, individuals need to provide personal information, medical history, and contact details as required.

What is the purpose of application for initial medical?

The purpose of the application for initial medical is to gather necessary information for conducting a medical examination.

What information must be reported on application for initial medical?

Information such as personal details, medical history, and contact information must be reported on the application for initial medical.

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