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  • Ar Surgical Clinic Information For Case History File 2012

Get Ar Surgical Clinic Information For Case History File 2012-2025

The Surgical Clinic Of Central Arkansas INFORMATION FOR CASE HISTORY FILE DATE: (PLEASE COMPLETE ALL ITEMS. PLEASE PRINT) PATIENT INFORMATION PATIENTS NAME: SS#: First Middle Last DATE OF BIRTH: AGE:.

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Requests for medical records may be made by returning an Authorization for Disclosure of Health Information form via mail or fax to 610.356. 3167.

Definition of an Ambulatory Surgical Center (ASC) Medicare-certified ambulatory surgical centers (ASCs) operate exclusively for the purpose of providing surgical services to patients who do not require hospitalization and expected duration of services does not exceed 24 hours.

No walk-in services available. Call 610-526-7360 for an appointment.

To obtain a copy of your medical record in Pennsylvania, start by asking your healthcare provider about their specific procedure. In most cases, you'll need to fill out a form and then make a request in writing.

An Outpatient Surgery Setting can be owned by an association, corporation, firm, partnership, or individual person.

A medical record number (MRN) is a unique identifier assigned to a patient in an electronic health record (EHR), practice management, or healthcare IT system. The MRN is used to keep track of medical history, diagnoses, treatments, and other important information related to patient care.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232