Get Patient Review And Coordination Referral Form - Dshs - Dshs Wa

This guide provides a clear, step-by-step approach to completing the Patient Review And Coordination Referral Form - DSHS - Dshs Wa online. Whether you are a provider or a user seeking assistance, this comprehensive outline will help you navigate the form efficiently.

Follow the steps to accurately complete the form online.

1. Click the ‘Get Form’ button to access the Patient Review And Coordination Referral Form and open it in your preferred editor.
2. Begin by filling out the referral source section. Enter the contact name, business organization, and their telephone and fax numbers. This information helps establish who is making the referral.
3. Next, complete the client information section. Provide the client’s name, PIC number, address, date of birth (DOB), and other identifying details. Ensure all names are spelled correctly and information is accurate.
4. In the reason for referral section, clearly specify why you are making this referral. This field should provide context and any relevant concerns for the medical assistance clients.
5. If you are a provider and are willing to be the client’s primary care provider, primary pharmacy, or hospital, provide your name and phone number in the designated area.
6. Review all entries for accuracy and completeness. It is important to fill out as much of the form as possible for effective processing.
7. Finally, choose to save your changes, download the form, print it out, or share it as needed. Ensure you send the completed form by the preferred method: encrypted email, fax, or mail.

Start completing your Patient Review And Coordination Referral Form online today for efficient processing.