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Virginia Pediatrics and Adolescent Medicine, PLC 5275 Lee Highway Suite 200 Arlington, VA 22207 (703)5331580 phone (703)5331689 fax NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT I understand that under
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Obtain the Virginia pediatric and adolescent form from a healthcare provider or online platform.
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Fill out the patient's personal information accurately, including name, date of birth, address, and contact information.
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Parents or legal guardians of children and adolescents who are seeking medical care in Virginia.
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Virginia Pediatric and Adolescent is a form used in Virginia to report healthcare services provided to pediatric and adolescent patients.
Healthcare providers who offer services to pediatric and adolescent patients in Virginia are required to file the Virginia Pediatric and Adolescent form.
The Virginia Pediatric and Adolescent form can be filled out online or manually, following the instructions provided by the Virginia Department of Health.
The purpose of Virginia Pediatric and Adolescent form is to track and monitor healthcare services provided to pediatric and adolescent patients in Virginia.
The Virginia Pediatric and Adolescent form requires information on the healthcare services provided, patient demographics, and any follow-up care needed for pediatric and adolescent patients.
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