Get Face Sheet

Completing the Face Sheet is an essential step in managing your healthcare information efficiently. This guide will help you navigate through each section of the form, ensuring you provide all necessary details accurately.

Follow the steps to fill out the Face Sheet with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient’s full name in the designated fields for first, middle initial, and last name.
3. Fill in the street address, ensuring it is written clearly to avoid any miscommunication regarding location.
4. Complete the fields for city, state, and zip code, making sure they match the patient’s residence for accurate identification.
5. Indicate the patient’s sex by selecting the appropriate option provided on the form.
6. Enter the social security number and date of birth in the specified formats to maintain consistency.
7. Provide home and work phone numbers, as well as an alternative contact number, ensuring that at least one number is active.
8. List the name of the employer and fill in the spouse's information, if applicable, including their name, date of birth, social security number, and employer.
9. Identify the referring physician and the primary care or family physician to facilitate continuity of care.
10. List all family members and friends who may receive limited information regarding healthcare. Include their names clearly in the provided space.
11. Read and understand the consent section regarding the release of health information and fill in the signature field along with the date.
12. Once all fields are completed, review the form for accuracy and clarity before proceeding to save changes or download the completed document.

Start completing your documents online today to ensure your healthcare information is up to date.