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Get Stanford International Patient Information Form 2019-2025
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How to fill out the Stanford International Patient Information Form online
Filling out the Stanford International Patient Information Form online is a crucial step for international patients seeking medical services. This guide provides thorough instructions to assist you with each section of the form, ensuring a seamless process tailored to your needs.
Follow the steps to complete the form accurately and efficiently.
- Press the ‘Get Form’ button to access the Stanford International Patient Information Form and open it for editing.
- Start by filling in your contact information, including your full name, date of birth, sex, and, if applicable, your U.S. Social Security number. Additionally, enter your foreign address and provide your contact numbers and email.
- Next, complete the U.S. address for billing if you have one; if not, leave that section blank. Remember that all patients can access their billing information through MyHealth.
- Proceed to the patient employment information section, where you will provide the name of your employer, occupation, and employer's address along with their contact numbers.
- If you have a U.S. contact, fill in their information, including their name, relationship to you, address, and contact information.
- In the medical information section, indicate your diagnosis and remember to attach translated medical records in PDF format. It is important not to send these files via external sites.
- State any special appointment requests or your availability for these appointments.
- In the international insurance section, specify if you have international insurance and include the required documentation. Ensure that the insurance can be used for expenses exceeding $1,000 and provide a letter of guarantee.
- In the IMS services requested section, indicate whether you need interpreter services or accommodations. Provide relevant details such as the language for interpretation or price range for accommodations.
- If you require airport transportation, check 'Yes' and provide flight details and the number of persons traveling.
- List any special needs or requests you may have, attaching an additional page if necessary.
- Lastly, complete the referral information by stating who referred you and how you learned about the services offered.
- After completing all sections, you can save your changes, download, print, or share the form.
Start filling out your Stanford International Patient Information Form online today.
To request your medical records from Stanford, start by accessing their patient portal or calling the medical records department. International patients may need to complete the Stanford International Patient Information Form as part of the request process. This method ensures your request is processed promptly and without delays.
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