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STATED QUICK QUALITY URGENT CARE REGISTRATION FORM (Please Print) Today's date:PCP:PATIENT INFORMATION Patients last name:First:Is this your legal name? Middle:(Former Name) Mr. Mrs. Marital status
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Gather all necessary personal information such as name, date of birth, and contact information.
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Who needs stat med urgent care?

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Individuals who require immediate medical attention for non-life-threatening conditions.
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People with minor injuries or illnesses such as sprains, strains, minor cuts, or flu-like symptoms.
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Individuals seeking convenient and accessible healthcare services without the need for an appointment.
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Stat Med Urgent Care is a medical facility that provides immediate care for non-life-threatening illnesses and injuries, offering a convenient alternative to emergency rooms for prompt medical attention.
Individuals seeking immediate medical attention for urgent health issues are generally required to visit and file necessary documentation at Stat Med Urgent Care.
To fill out the necessary forms at Stat Med Urgent Care, a patient should provide personal information, describe their medical concerns, and provide any relevant insurance information.
The purpose of Stat Med Urgent Care is to provide timely medical care for patients with acute conditions, ensuring they receive the attention they need without the long wait times associated with emergency departments.
The information that must be reported includes patient name, date of birth, medical history, current symptoms, and any medications currently being taken.
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