Get Hip Referrals Forms Online

Filling out the Hip Referrals Forms Online is a crucial step for users seeking primary care services through the Health Integration Project. This guide provides clear and structured instructions to help you navigate each section effectively.

Follow the steps to complete your form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by checking the boxes that apply to the consumer's eligibility criteria. Make sure that at least two criteria are fulfilled to proceed.
3. Fill in the consumer's name, date of birth (DOB), Anasazi number, and social security number (SSN). Ensure that the information is accurate and clearly written.
4. Enter the phone numbers, including home and cell. This will help facilitate communication regarding the referral.
5. Provide the mailing address for the consumer. Make sure it is complete and up to date.
6. Indicate the primary insurance coverage and plan/policy/ID number. This information is essential for processing the referral.
7. If applicable, fill in the guardian's name and phone number. If not relevant, select N/A.
8. Enter the name of the current primary care provider (PCP) and any current medical problems. Select N/A if this information does not apply.
9. In the primary assignment field, check one appropriate option from the list provided.
10. Record the referral date in the designated field.
11. Complete the primary SAI name and contact number, consulting with the SAI if you are not the primary contact.
12. Determine the appointment priority by selecting either ROUTINE or SAME DAY/URGENT. Follow the corresponding instructions for each priority.
13. After filling out all fields, review the information for accuracy and completeness. Make any necessary edits.
14. Once satisfied with the completed form, you can save changes, download a copy, print it, or share it as needed.

Complete your documents online today to ensure timely access to necessary health services.