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Get Osu Physician Referral Form 2020-2025
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How to fill out the Osu Physician Referral Form online
Filling out the Osu Physician Referral Form online is a straightforward process that helps facilitate the referral for patients. This guide provides step-by-step instructions to ensure you accurately complete the form and submit it efficiently.
Follow the steps to complete the Osu Physician Referral Form online
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by indicating whether the referral is urgent. Select 'Yes' if an urgent appointment is required, otherwise select 'No'. If urgent care is needed, users are advised to call 614-293-5123 for immediate assistance.
- Fill in the patient information section completely. This includes the patient’s first name, last name, middle name, and gender. Provide the last four digits of the patient’s Social Security Number, marital status, date of birth (in mm/dd/yyyy format), and contact information, such as the primary phone number.
- Enter the patient’s address details including street address, city, state, country, and zip code.
- Specify the reason for the referral by describing the patient's condition or situation in the 'Reasons for Referral' section.
- If applicable, write the preferred physician or provider’s name, along with the department or specialty area they belong to.
- In the referring provider information section, fill out the referring provider's first and last name, title, and NPI number. Also, include their street address, city, state, zip code, phone number, extension, and fax number.
- Once all fields are completed, double-check the form for any missing information that may delay processing. Make sure to include any clinical documentation pertinent to the referral.
- After ensuring the form is complete and accurate, save your changes. You can then proceed to download, print, or share the form as needed. Remember to fax all documents to 614-293-1456 for processing.
Complete your documents online today for a seamless referral experience.
Writing a referral form for a patient requires including the patient's name, contact information, and reason for the referral. Be clear and concise in detailing the condition that necessitates the referral. Utilizing the osu physician referral form can provide a structured format to ensure that all relevant information is included and presented clearly.
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