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Are you under care by another provider for this diagnosis:Pain Body Diagram:Please use these symptoms to mark the painPins/ needles 00 Burning XXDull ache ZZ Sharp/ Stab / /What makes your symptoms
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Obtain the form labeled 'Are you under care' either online or from a healthcare provider.
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Read the instructions on the form carefully to understand what information is required.
03
Fill out your personal information such as name, date of birth, address, and contact details.
04
Indicate whether you are currently under the care of a healthcare provider and provide details if applicable.
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Review the completed form for accuracy and sign and date it where required.

Who needs are you under care?

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Individuals who are seeking medical treatment or consultation
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Patients who are on medication or receiving ongoing medical care
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Individuals with chronic health conditions that require regular monitoring
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Are you under care is a form or declaration that an individual may need to submit to indicate whether they are currently receiving medical care or support services.
Individuals who are receiving medical care, support services, or who are under the care of a healthcare professional are typically required to file this declaration.
To fill out the 'are you under care' form, individuals should provide their personal information, details about the medical care or services they are receiving, and any relevant healthcare provider information.
The purpose of 'are you under care' is to document an individual's current healthcare status and ensure that they are receiving appropriate support and services.
Information that must be reported typically includes the individual's name, contact information, type of care received, name of the healthcare provider, and duration of the care.
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