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Institutional investors / Health economics / Data privacy / Health Insurance Portability and Accountability Act / Privacy law / Insurance / Primary care physician / Medical prescription / Medical record / Medicine / Health / Financial institutions


PATIENT REGISTRATION Date: _________________________________ PLEASE PRESENT YOUR DRIVER’S LICENSE AND INSURANCE CARDS TO RECEPTION DESK. • INSURANCE CO-PAYMENTS ARE EXPECTED BEFORE SERVICES ARE RENDERED.
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Document Date: 2013-12-12 00:07:10

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Company

PREFERRED LABORATORY / City ST Zip Code Secondary Insurance Company / Valley Medical Group / City ST Zip Code Primary Insurance Company / Valley Physician Services Inc. / /

Facility

Hospital Address / /

IndustryTerm

insurance coverage / insurance company request / insurance policy / healthcare environment / co-insurance amounts / health care services / telephone answering machine / healthcare / non-covered services / bank / insurance payments / insurance plan / insurance card / insurance / bill participating insurance companies / /

MedicalCondition

pain / injury / HIV/AIDS / /

MedicalTreatment

pain management / surgery / /

Movie

NEXT OF KIN / /

NaturalFeature

Valley Medical Group (VMG)* / Valley Medical Group PCP / /

Position

Physician / DRIVER / Representative / care physician / Referring Physician / /

Technology

cellular telephone / /

SocialTag