Get Ga Laureate Medical Group Continuity Of Care Request Form 2018-2025

Filling out the GA Laureate Medical Group Continuity Of Care Request Form online is an essential step in ensuring seamless communication between healthcare providers. This guide will provide you with clear, step-by-step instructions to help you complete the form efficiently and accurately.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In the first section, enter the patient’s name in the 'Patient Name' field, followed by their date of birth in the format MM/DD/YYYY in the 'Patient DOB' field.
3. Next, fill in the 'Requester’s Name' field with your name, followed by the 'Requesting Facility/Provider' name and associated phone number in the respective fields.
4. Indicate the desired documentation by specifying the previous two visits or two specific items/dates. Clearly write the details in the provided spaces.
5. If the request exceeds two items, you will need to complete a Release of Information form, which can be found on the Laureate Medical Group website under Patient Services – Forms.
6. Indicate whether the patient is currently in the office by circling 'Yes' or 'No.' If they are present and it is a STAT request, ensure to also call the appropriate office.
7. Finally, return the request via fax to the appropriate location by entering the correct fax number included in the form. Ensure all information is accurate before sending.
8. After completing the form, save your changes, then download, print, or share the completed form as needed.

Complete your forms online today for a smooth healthcare experience.