Get the free Adventist Hospice Physician Fax Form - adventisthealthorg

HOSPICE REFERRAL INTAKE FAX FORM HOSPICE FAX REFERRALS: (503) 2616080 HOSPICE PHONE REFERRALS: (503) 2516192 PATIENT NAME: DOB: PHONE: INSURANCE: REFERRING PHYSICIAN: PRIMARY CARE PHYSICIAN: DIAGNOSIS:

How to fill out adventist hospice physician fax

How to fill out adventist hospice physician fax:

1. Start by entering the date on the specified field. Make sure to write the complete date including the day, month, and year.
2. Next, you'll need to provide the name of the physician who is referring the patient to the Adventist hospice. This includes the first name, last name, and any applicable credentials such as MD or DO.
3. Enter the physician's contact information, including their phone number and fax number. This is important for the hospice staff to easily reach out if needed.
4. Fill in the patient's details, such as their full name, date of birth, and contact information. It is crucial to provide accurate information to ensure proper care and communication.
5. Specify the reason for the referral. This could include the patient's medical condition and any additional details that would help the hospice team understand the situation better.
6. Provide any necessary medical history or relevant medical records in the designated section. This may include recent lab results, imaging reports, or summaries from previous medical visits.
7. Finally, make sure to sign the fax using the physician's signature. This confirms that the referral is authorized by the physician and that they have reviewed the patient's information carefully.

Who needs adventist hospice physician fax?

1. Patients who require specialized end-of-life care in a hospice setting may need an Adventist hospice physician fax. This fax serves as a referral from the patient's primary physician or healthcare provider, indicating that the patient would benefit from hospice services.
2. The Adventist hospice physician fax is typically required to initiate the admission process and ensure that the patient receives the necessary care and support during their final stages of life. It helps in streamlining communication between the referring physician and the hospice team, ensuring a smooth transition for the patient.
3. Hospice care focuses on providing comfort, pain management, and emotional support to individuals with terminal illnesses. Therefore, patients who have been diagnosed with a terminal condition and their primary physicians may utilize the Adventist hospice physician fax to access specialized end-of-life care.

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What is adventist hospice physician fax?

Adventist hospice physician fax is a document used for communicating medical information between healthcare providers.

Who is required to file adventist hospice physician fax?

Adventist hospice physicians are required to file the physician fax.

How to fill out adventist hospice physician fax?

Adventist hospice physician fax can be filled out by providing the required medical information in the designated fields.

What is the purpose of adventist hospice physician fax?

The purpose of adventist hospice physician fax is to facilitate the sharing of medical information among healthcare providers.

What information must be reported on adventist hospice physician fax?

Adventist hospice physician fax must include patient's medical history, current condition, treatment plan, and any relevant test results.