Get Imp Wellness

Filling out the Imp Wellness form is a crucial step in managing your medical information and ensuring your privacy preferences are respected. This guide will provide you with clear, step-by-step instructions to complete the form accurately and efficiently.

Follow the steps to complete the Imp Wellness form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by carefully filling out the authorization section. Write your name where indicated to authorize the Internal Medicine & Pediatrics Wellness Center to disclose your medical information.
3. Next, specify the name of the person or persons you are allowing to receive your medical information. Make sure this is clearly displayed in the designated field.
4. Indicate whether you permit the medical center to share billing and account information with the authorized person by marking the appropriate option.
5. If you prefer a specific method of communication for appointments and test results, indicate your choice. Be aware that email is not used for sensitive information due to potential interception.
6. Provide the email address if you selected to receive updates via email. Ensure that the address is correct to avoid any miscommunication.
7. Specify whether you allow messages to be left on your answering machine or voicemail by selecting the appropriate option.
8. If you do not wish to receive calls at your home number, please provide an alternate contact number in the section provided.
9. Indicate whether you would like appointment reminders or other correspondence mailed to your home. If not, please provide an alternate mailing address.
10. Finally, sign and date the form. Ensure your signature is placed correctly, indicating your consent for the details provided.
11. Once you have completed all sections, save your changes, then choose to download, print, or share the form as necessary.

Complete your documents online today to ensure your preferences are accurately reflected!