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Email: radiology@hermitageclinic.iePATIENT DETAILS
(Please Print)Title:First Name:DOB://Surname:
Sex:MAN:__Address:
Phone:
ED:Email:
GP:CON:INPATIENT: Room:Patient Infection Status:
Falls Risk Score:Previous
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How to fill out fax and contact phone
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Start by writing your name and contact phone number at the top of the fax cover sheet.
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Include the recipient's name, fax number, and contact phone number below your information.
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What is fax and contact phone?
Fax and contact phone are methods of communication used to transmit information.
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The purpose of fax and contact phone is to facilitate communication and ensure important information is received.
What information must be reported on fax and contact phone?
Typically, fax and contact phone require details such as sender's name, recipient's name, phone number, and message.
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