Get Ga Laureate Medical Group Continuity Of Care Request Form 2020-2025

This guide provides clear and supportive instructions for users on how to complete the GA Laureate Medical Group Continuity Of Care Request Form online. Following these steps will help ensure that you accurately submit your request for continuity of care documentation.

Follow the steps to successfully complete your request form.

1. Press the 'Get Form' button to access the form and open it in your preferred editor.
2. Begin by entering the patient's name in the designated field to ensure the request is for the correct individual.
3. Provide the patient's date of birth in MM/DD/YYYY format to confirm their identity and validate the request.
4. Fill in the requester's name to identify who is making the continuity of care request.
5. Enter the name of the requesting facility or provider to ensure proper routing of the request.
6. Input the facility's phone number for quick communication if needed.
7. Include the facility's fax number to send any necessary documents.
8. In the section labeled 'Laureate Medical Group Provider’s Name,' list the provider who is associated with the patient.
9. Select the type of documentation requested by checking the appropriate box (e.g., Abstract of Medical Record, Labs Only, Radiology Only, EKG Only).
10. Indicate whether the patient is currently in the office by selecting 'Yes' or 'No' and note if this is a STAT request.
11. Review all entered information to ensure accuracy before submitting.
12. Once completed, users can save changes, download the form for their records, print it out, or share it as necessary.

Complete your GA Laureate Medical Group Continuity Of Care Request Form online for efficient processing.