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Urology Centers of Alabama Dispensary 3485 Independence Drive Homewood, AL 35209 Phone (205) 4450183 Fax (205) 2635153Dear Patient, The team members of Urology Centers of Alabama (UCA) Dispensary
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01
Start by providing your personal information such as name, date of birth, address, and contact information.
02
Fill out your medical history including any past or current medical conditions, medications you are taking, and any allergies you may have.
03
Indicate your primary care physician and any specialists you may be currently seeing.
04
Complete the section on your cannabis use history, including how often you use cannabis and for what purposes.
05
Sign and date the form to certify that all the information provided is accurate.
Who needs new-patient-dispensary-packet-7?
01
Individuals who are new patients at a dispensary and are required to fill out paperwork prior to receiving any products or services.
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What is new-patient-dispensary-packet-7?
It is a form required by the dispensary for new patients.
Who is required to file new-patient-dispensary-packet-7?
New patients visiting the dispensary for the first time.
How to fill out new-patient-dispensary-packet-7?
The form can be filled out by providing personal and medical information.
What is the purpose of new-patient-dispensary-packet-7?
The purpose is to gather necessary information about new patients for record-keeping and legal compliance.
What information must be reported on new-patient-dispensary-packet-7?
Personal details, medical history, and reason for visit must be reported.
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