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ANN WILSON ONSITE TEACHING CLINIC REFERRAL FORM PEDIATRICS Revised 05/2023Patient Information: Please complete the form. Type or print legibly. Childs First name: ___ Childs Last name: ___ Date of
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Start by gathering all the necessary information such as personal details, medical history, and insurance information.
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Contact Eastern Carolina Pediatrics to schedule an appointment or inquire about the specific forms they require for filling out.
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Arrive at the pediatric clinic with your child and the completed forms.
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Review the forms with the receptionist or any available staff to ensure all required fields have been properly filled out.
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Eastern Carolina Pediatrics caters to families residing in the Eastern Carolina region who prefer a specialized pediatric clinic for their child's healthcare needs.
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Eastern Carolina Pediatrics is a healthcare provider specializing in the pediatric care of children and adolescents in the Eastern Carolina region.
Healthcare professionals and organizations that provide services through Eastern Carolina Pediatrics may be required to file associated documentation.
To fill out documentation related to Eastern Carolina Pediatrics, individuals should complete the required forms with accurate patient information and adhere to any specific guidelines provided by the organization.
The purpose of Eastern Carolina Pediatrics is to provide comprehensive medical care for children, including preventive health services, treatment of illnesses, and management of chronic conditions.
Information such as patient demographics, medical history, treatment plans, and billing information must be reported on the Eastern Carolina Pediatrics documentation.
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