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Confidential Patient Health RecordTodays Date:___/___/___How did you hear about us?
Close to home/workFamily ___
Dr. ___
Yellow pages Friend ___
Drove by
HospitalCoWorker ___
Insurance PlanPersonal
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How to fill out home phone - ext
How to fill out home phone - ext
01
Locate the section on the form designated for home phone number.
02
Enter the area code followed by the phone number.
03
If applicable, include the extension number in a separate field or next to the phone number.
Who needs home phone - ext?
01
Individuals who may need to contact a person at their residence or are requesting a callback from a household member may need the home phone number with extension.
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What is home phone - ext?
Home phone - ext is a field on a form used to enter the extension number for a home phone.
Who is required to file home phone - ext?
Individuals who have a home phone with an extension number are required to fill out the home phone - ext field.
How to fill out home phone - ext?
To fill out the home phone - ext field, simply enter the extension number associated with your home phone.
What is the purpose of home phone - ext?
The purpose of home phone - ext is to provide additional contact information for individuals with a home phone that has an extension number.
What information must be reported on home phone - ext?
Only the extension number for the home phone needs to be reported on the home phone - ext field.
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