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ImageGuided Pain Therapy REQUISITION Phone: 403.984.5470 Fax: 403.984.5469 #200, 1402 8 Avenue Calgary, AB T2N 1B9 PATIENT INFORMATION Home Phone: Place patient label here Date of Request: D/ DD M/
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Caleo Health is a health and wellness company that offers telehealth services and virtual doctor visits.
Individuals who have used the services of Caleo Health or have received medical treatment from their affiliated healthcare providers may be required to file Caleo Health forms for reporting purposes.
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The purpose of Caleo Health forms is to track health-related expenses, monitor medical services received, and report any potential conflicts of interest in healthcare arrangements.
Information such as name, address, date of service, type of service received, healthcare provider details, and any associated costs or payments must be reported on Caleo Health forms.
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