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3507 Post Street Clinton, NY 13323315.557.6848megamotionpt@gmail.comAUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATIONPATIENT NAME: ___DATE OF BIRTH: ___ADDRESS: ___CONTACT NO.:___I hereby authorized
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Megamotion Physical Therapy Clinic is a healthcare facility that specializes in providing physical therapy services to help patients recover from injuries, manage pain, and improve physical function.
Patients seeking physical therapy services at Megamotion may be required to fill out forms for insurance reimbursement, referral information, and medical history as part of their treatment process.
To fill out the Megamotion Physical Therapy Clinic forms, you should provide accurate personal information, medical history, details of the injury or condition, insurance information, and any other required details as instructed on the form.
The purpose of Megamotion Physical Therapy Clinic is to provide patients with therapeutic services aimed at rehabilitation, pain management, and functional improvement through personalized treatment plans.
Patients must report their personal details, medical history, description of the injury or condition, current medications, and insurance information on the Megamotion Physical Therapy Clinic forms.
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