Get Lima Memorial Health System Physician Order Set Request Form

Filling out the Lima Memorial Health System Physician Order Set Request Form online is a straightforward process that facilitates your order set requests. This guide provides clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to acquire the form and access it in the online editor.
2. Enter the date of request in the designated field to indicate when you are submitting the request.
3. Select the request type by marking the appropriate checkbox for 'New Order Set,' 'Revise Order Set,' or 'Delete Order Set.'
4. Specify the order set name clearly in the provided field to identify the order set you are requesting.
5. List the full names of all physicians making the request in the section labeled 'Physician(s) Making Request.'
6. Fill out all required contact information, including phone number, fax number, and email address.
7. Determine the order set priority by checking the appropriate box: 'Emergent,' 'Regulatory,' or 'Routine.'
8. Save your changes to the form, ensuring all fields are completed accurately. You can then download, print, or share the form as needed before submitting it.

Complete and submit your document online today!