Get Cigna Continuity Of Care Form

Filling out the Cigna Continuity of Care Form online is a crucial step for individuals seeking to ensure that they can continue receiving necessary medical services during transitions in their care. This guide provides a clear overview and step-by-step instructions to assist you through the process.

Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to access the Cigna Continuity of Care Form and open it in your preferred document editor.
2. Begin by entering the necessary personal information in the designated fields. This includes your employer's name, the employee's name, home address, policy number, and contact details.
3. Provide the patient's details. Include the patient's name, date of birth, and relationship to the employee. This is essential for identifying the individual receiving care.
4. Indicate whether the patient is currently pregnant and in the second or third trimester. If yes, specify if the pregnancy is considered high risk.
5. Answer the questions regarding the patient’s current treatment status for acute conditions, scheduled surgeries, or ongoing treatments such as chemotherapy.
6. Fill in the health care professional's information, including their name, specialty, contact number, and address. Accurately documenting this is important for the continuity of care.
7. Detail the medical condition for which you are requesting Transition of Care or Continuity of Care. Be as descriptive as possible, including any critical information related to the patient's treatment plan.
8. Sign and date the form at the bottom. If the patient is a minor, ensure that a guardian's signature is included.
9. After reviewing the completed form, save any changes, and download or print the document if needed for submission. Ensure you submit the form promptly to support the request for care continuity.

Submit your Cigna Continuity of Care Form online today to ensure uninterrupted medical care.