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#102 6625 152A Street
Surrey, B.C. V3S 3L4
Tel: 6045031160
www.smileplus.caNEW PATIENT FORM
attention. This form is STRICTLY CONFIDENTIAL. Personal Information
NAMED ATE OF BIRTHADDRESSPOSTAL WODEHOUSE
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How to fill out new patient formsmile plus
01
Obtain new patient formsmile plus from the healthcare provider's office or website.
02
Fill out the required personal information such as name, address, date of birth, and contact information.
03
Provide information on your medical history, including any current medications and past surgeries.
04
Answer any additional questions regarding your health and insurance coverage.
05
Review the completed form for accuracy and sign where indicated.
Who needs new patient formsmile plus?
01
Patients who are new to a healthcare provider and are seeking medical treatment or services.
02
Patients who have not completed a patient information form in the past or need to update their information.
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What is new patient formsmile plus?
New patient formsmile plus is a form that new patients are required to fill out when visiting Smile Plus clinic for the first time.
Who is required to file new patient formsmile plus?
All new patients visiting Smile Plus clinic for the first time are required to file new patient formsmile plus.
How to fill out new patient formsmile plus?
New patients can fill out the new patient formsmile plus either online through the clinic's website or in person at the clinic on the day of their appointment.
What is the purpose of new patient formsmile plus?
The purpose of new patient formsmile plus is to collect important information about the patient's medical history, insurance information, and contact details.
What information must be reported on new patient formsmile plus?
New patient formsmile plus typically asks for information such as name, date of birth, address, phone number, emergency contact, insurance provider, and medical history.
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