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Thomas G. Koch D.C.
Andrea L. Goff D.C. All Styles, NEW PATIENT REGISTRATION MASSAGETodays Date ___Name ___
LastFirstMIAddress ___
(Complete Mailing)Street#CityStateZipSocial Security # ___ ___ ___
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How to fill out new patient registration -massage
How to fill out new patient registration -massage
01
Obtain new patient registration form from the massage clinic.
02
Fill out personal information such as name, address, phone number, and date of birth.
03
Provide any medical history or allergies that the massage therapist should be aware of.
04
Sign and date the form to acknowledge that the information provided is accurate.
Who needs new patient registration -massage?
01
Anyone who is receiving a massage for the first time at the clinic needs to fill out a new patient registration form.
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What is new patient registration -massage?
New patient registration -massage is the process of registering a new patient for massage therapy services.
Who is required to file new patient registration -massage?
All individuals who are seeking massage therapy services for the first time are required to file a new patient registration -massage.
How to fill out new patient registration -massage?
To fill out new patient registration -massage, you will need to provide your personal information, medical history, and consent for treatment.
What is the purpose of new patient registration -massage?
The purpose of new patient registration -massage is to gather necessary information about the patient's health and history to ensure safe and effective massage therapy treatment.
What information must be reported on new patient registration -massage?
Information such as full name, date of birth, contact information, medical history, current health conditions, and any medications being taken must be reported on new patient registration -massage.
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