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Family Centers Health Care Accepting Medical & Dental

Family Centers Health Care Accepting Medical & Dental 2025

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The document is a welcome letter and patient intake form for Family Care Health Centers (FCHC) in Greenwich, CT. It outlines the procedures and requirements for first-time appointments, including necessary documents, appointment confirmation policies, medication refill processes, and patient rights and responsibilities. The document emphasizes the importance of coordinated care through a primary care medical home model, detailing the clinic's mission to provide comprehensive and personalized healthcare services.

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Click ‘Get Form’ to open the Family Centers Health Care Accepting Medical & Dental form in the editor.
Begin by entering your personal information in the 'Patient Name' section, including your first and last name, date of birth, and contact details.
Proceed to fill out the 'Patient Intake Information Form,' ensuring you provide accurate details such as your address, phone numbers, and insurance information.
Complete the 'Patient Financial Information Form' by indicating your insurance coverage and relationship to the insured. Make sure to include policy numbers where required.
Review and sign the 'Consent to Treat/Billing' section, confirming that you understand your rights and responsibilities as a patient.
Finally, ensure all sections are filled out completely before saving or submitting your form for processing.

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2020	4.8 Satisfied (60 Votes)

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