Get Block Time Request Form - Emmc

Filling out the Block Time Request Form - Emmc is essential for surgeons requesting designated operating time. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Block Time Request Form - Emmc and open it in your preferred editing software.
2. In the first section, enter the surgeon's name in the designated field. Ensure that the spelling is correct for accurate processing.
3. Select 'New Block holder' by checking the corresponding box to indicate that this is a request for a new block of time.
4. Input the number of new or additional hours being requested in the provided space. Be specific to avoid misunderstandings.
5. List the preferred block times and days of the week in order of preference. It is important to provide three options to facilitate scheduling.
6. Identify any days of the week that are unsuitable for the surgeon’s new block time by writing them in the designated area.
7. Fill out the surgeon office contact information, ensuring to include an email address and phone number for follow-up communication.
8. Once all sections are filled out, review the form for accuracy and ensure that all necessary fields have been completed.
9. Finally, save any changes you’ve made, and download or print the form. Then, submit it to Missy Peasley via email or fax, as specified.

Complete your online Block Time Request Form today for efficient scheduling!