Online outpatient consent form rex hospital nc: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field, allowing the doctors and staff of UNCPN to provide necessary medical treatment.
Review the sections detailing treatment types, including lab tests and diagnostic tests. Ensure you understand what services may be provided.
Fill out the release of health information section by providing names and contact details for individuals who can receive your health information if you cannot be reached.
Acknowledge financial policies by reading through them carefully. If applicable, enter your insurance information to avoid unexpected costs.
If required, provide the last four digits of your social security number for identification purposes.
Sign and date the form at the bottom, confirming that you understand and agree to all terms outlined in the document.

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