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IV Infusion Please fax a copy of patients Demographics, Insurance Information, Current Lab Results, H&P, Current Medications and Recent Visit Notes.Referral status: mm Dose or frequency changeNEW
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Please fax a copy refers to a request for sending a duplicate or version of a document via fax.
Individuals or organizations that need to submit necessary documentation as requested by a recipient or regulatory body are required to file.
To fill out please fax a copy, ensure that all relevant fields in the original document are accurately completed before sending the fax.
The purpose is to provide an exact duplicate of a document for review, verification, or record-keeping.
The original document's details, sender's contact information, and the recipient's fax number must be included.
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