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Dr. Pierre Rouse, Patient History and Initial Health StatusPERSONAL HISTORY Name:Address:City:State:Zip Code:Home Phone:Birth Date:Sex:Cell Phone:Email Address:Social Security #:Driver's License Number:Employer:Type
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Gather all necessary information such as personal details, insurance information, medical history, etc.
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Submit the completed form to the Infinity Healthcare Group PC office either in person or via email.

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Individuals who are seeking medical care from Infinity Healthcare Group PC.
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Infinity Healthcare Group PC is a healthcare group that provides various healthcare services to patients in the community.
Infinity Healthcare Group PC is required to file by healthcare providers and professionals operating within the group.
Fill out the required information such as patient care services offered, revenue generated, expenses incurred, and any other pertinent financial and operational information.
The purpose of infinity healthcare group pc is to provide a comprehensive overview of the group's operations and financial performance.
Information such as patient demographics, services provided, revenue sources, expenses, and any regulatory compliance information.
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