Form locator 17, Name of Referring Physician or Other Source, can include the name of a relative or friend who referred the patient to the physician's office.

Name: Form locator 17, Name of Referring Physician or Other Source, can include the name of a relative or friend who referred the patient to the physician's office.
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Question

Quizplus · Accepted Answer

Form locator 17 is specifically for the name of a referring, ordering, or supervising physician, not a relative or friend.

Form Locator 17, Name of Referring Physician or Other Source