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Get and Sign Patient Demographics Template  Form

Get and Sign Patient Demographic Form

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#: Relative not living with you: Relative’s Phone #: WHO REFERRED YOU TO OUR OFFICE: WHO IS YOUR PRIMARY CARE PHYSICIAN: _________________________________ PHONE #: _______________________ RESPONSIBLE / INSURED PARTY INFORMATION: --- IF DIFFERENT FROM PATIENT NAME: ADDRESS: RELATIONSHIP TO PATIENT: CITY: STATE: ZIP: HOME PHONE#: CELL #: EMPLOYER: WORK PHONE #: __________________________________ SOCIAL SECURITY #: DRIVER'S LICENSE #: DATE OF INJURY: ________ WORK RELATED?...
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Instructions and help about patient demographics template

You could be a general dentist orthodontist or an oral surgeon is your clinic tired of managing paper documents at your front office staff spends a lot of time in printing forms arranging on clipboards get them completed read bad handwriting and review the forms to ensure they are properly filled then staff adds information into the practice management system and at the end scan forms into practice management system this process not only makes your clinic inefficient but is also at high risk of HIPAA violation if the patient forms get lost stolen or get in the wrong hands more than that if the forms are not properly completed the clinic is always at a legal risk how do we avoid risk and get more efficient introducing them consent team here at M consent develops custom iPad app for your clinic takes your paper forms like patient intake medical history dental history and consent forms and convert it into a custom branded beautiful iPad app, so basically you replace all your paperwork wit

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