Get Physician Office Integration Request To Discontinue Mail / Fax Reports

Filling out the Physician Office Integration Request To Discontinue Mail / Fax Reports form is an essential step for healthcare providers looking to streamline their communication processes. This guide will provide you with clear instructions on how to accurately complete the form online.

Follow the steps to complete the request form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. In Section A, start by entering the physician's full name, including the first, middle, last name, and initial. Ensure this information matches your official records.
3. Fill out the clinic contact person's name, email, phone, and fax numbers. This helps ensure the clinic can be contacted efficiently regarding the request.
4. Move to Section B, where you need to check the box indicating that you would like to stop receiving all transcribed reports by mail and/or fax. Make sure this is clearly marked.
5. In this section, sign and print your name, along with the date of completion. Your signature confirms your request to discontinue mail or fax reports.
6. After you have completed all sections, review the form one last time to confirm that everything is correct. You can either save changes, download, print, or share the filled form as needed.

Complete your documents online to ensure a smooth and efficient process.