FGP Demographic Form 5.6.10
... NYU Urology Associates ●150 E. 32nd St. ● New York, NY 10016 ● 646-825-6300 MEDICAL HISTORY PATIENT ... :________________________________________________________________________________________ __________________________________________________________________________________________________________________ Medications: (name and dosage) 1. ____________________________________ 2 ...
hie-fact-sheet-and-consent-bangla.pdf
... ”) and non-NYU Langone health providers who may request access to your medical records for purposes ... of current treatment (“Care Everywhere Providers”) to obtain access to your medical records through ...
hie-fact-sheet-and-consent-yiddish.pdf
... providers who may request access to your medical records for purposes of current treatment (“Care Everywhere ... Providers”) to obtain access to your medical records through a computer network operated by the HIE ...
perlmutter-social-work-flyer-mineola.pdf
... • Home meal delivery, home health care, and medical equipment • Support in communicating with family ... , friends, or medical team • Caregiver issues • Making decisions for future medical care (advance directives ...
perlmutter-socialwork-flyer-mineola.pdf
... • Home meal delivery, home health care, and medical equipment • Support in communicating with family ... , friends, or medical team • Caregiver issues • Making decisions for future medical care (advance directives ...
barrier-free-design-ot-referral.pdf
... : ________ ____________ Medical Diagnosis: ICD 10: Onset Date: _______ OT Prescription for: (please select) OT Barrier Free Design ...
fhc-heia-relocation-and-consolidation-heia.pdf
... on improving access and health outcomes for medically underserved populations. Lynnette Mawhinney is a health ... to create a medical home that will enable patients to access services more easily at a single location ...
NYU Langone Ambulatory Care Center East 41st Street | NYU Langone Health
Doctors at NYU Langone Ambulatory Care Center East 41st Street provide a variety of outpatient services.
fgp-workers-comp-no-fault-insurance-registration-form-4-30-18.pdf
... /CARRIER CASE #_ CLAIM REPRESENTATIVE/ADJUSTOR NAME_ PHONE # EXT_ FAX # (OTHER MEDICAL) INSURANCE: ID ... PROCEDURE? WHAT PART OF THE BODY? WERE YOU GIVEN ANY MEDICATION? (YES/NO) IF YES, PLEASE LIST _ HAVE YOU ...
perlmutter-social-work-flyer-manhattan-34th.pdf
... delivery, home health care, and medical equipment • Support in communicating with family, friends ... , or medical team • Caregiver issues • Making decisions for future medical care (advance directives) • End ...