Transcription of PROVIDER/TREATING INFORMATION - VeriClaim
1 PROVIDER/TREATING INFORMATIONID NUMBERSURNAMEFULL NAMESINITIALSGENDERHOME LANGUAGETITLEDATE OF BIRTHCELL NUMBEREMAIL ADDRESSTEL NUMBERFAX NUMBERPROVIDER PCNS NOHPCSA NODIARY SETTINGSAPPOINTMENT INTERVAL10 MIN15 MIN20 MIN30 MIN40 MINDAILY START TIMEDAILY END TIMEREMINDER TIME BEFORE APPOINTMENT 1 HOUR2 HOURS1 DAY2 DAYS3 DAYS1 WEEK2 WEEKSNONEMESSAGE BODY FOR REMINDER SMS(EXAMPLE: PLEASE REMEMBER YOUR APPOINTMENT WITH DR. INITIALS SURNAME ON <<DATE & TIME>>. PLEASE CANCEL IF YOU CANNOT MAKE IT). MAX 160 CHARACTERSPOSTAL ADDRESSPRACTICE TYPE DESCRIPTIONSERVICE CENTRE(S)
