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COURSE REGISTRATION FORM Please email or fax this registration form & payment to:Chicago Pediatric Therapy and Wellness Center Email: rose.mclean@cptwc.com FAX: (773) 3055543 Name ___Discipline ___ Address___ City___State___Zip___ Phone
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Chicago Pediatric FormRapy AMP is a specialized form designed for reporting pediatric therapy services administered in the Chicago area. It is used to collect data on treatments provided to children.
Providers of pediatric therapy services, including physical therapists, occupational therapists, and speech-language pathologists operating in Chicago, are required to file the Chicago Pediatric FormRapy AMP.
To fill out the Chicago Pediatric FormRapy AMP, providers must gather the necessary patient information, document the therapy services provided, and follow the instructions provided with the form to ensure all required fields are completed correctly.
The purpose of the Chicago Pediatric FormRapy AMP is to ensure proper documentation and reporting of pediatric therapy services for regulatory compliance, billing, and data collection purposes.
The form must report patient demographics, the types of therapies administered, duration of treatments, frequency of sessions, and any relevant notes about the patient's progress and outcomes.
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