Get the free Transition of Care Form - CenturyLink Benefits - Home

This form is intended for new enrollees to request continuing treatment with a non-participating provider after enrollment.

How to fill out transition of care form

How to fill out a transition of care form:

1. Start by gathering all the necessary information. This may include personal details, medical history, current medication list, and any other relevant documents.
2. Fill in the patient's personal information such as name, date of birth, address, and contact details. Make sure to provide accurate and up-to-date information.
3. Next, document the details of the healthcare provider or facility that is referring the patient. Include their name, address, contact information, and any additional details required.
4. Provide information about the receiving healthcare provider or facility. This should include their name, address, contact information, and any specific instructions or preferences they may have.
5. Record the reason for the transition of care. Explain the primary reason why the patient is being referred to another healthcare provider or facility. Include any relevant medical conditions or concerns.
6. List all current medications the patient is taking. Include the name, dosage, frequency, and any other specific instructions. It is important to accurately record this information to ensure continuity of care.
7. Document the patient's medical history. Include any previous diagnoses, surgeries, allergies, or chronic conditions that may be relevant to the transition of care.
8. Attach any supporting documents, such as medical records, lab results, or imaging reports. These documents can provide crucial information for the receiving healthcare provider and aid in the continuity of care.

Who needs a transition of care form:

1. Patients who are being referred from one healthcare provider or facility to another.
2. Individuals who are transferring their medical care from one location to another, such as moving to a new city or country.
3. Patients who require specialized care or treatments that are not available at their current healthcare provider.
4. Individuals who have recently been discharged from a hospital and need follow-up care from a different healthcare provider or facility.
5. Patients who are transitioning between different levels of care, such as moving from hospital care to home care or long-term care facilities.

For pdfFiller’s FAQs

How can I get transition of care form?

It's simple with pdfFiller, a full online document management tool. Access our huge online form collection (over 25M fillable forms are accessible) and find the transition of care form in seconds. Open it immediately and begin modifying it with powerful editing options.

How can I edit transition of care form on a smartphone?

The pdfFiller apps for iOS and Android smartphones are available in the Apple Store and Google Play Store. You may also get the program at https://edit-pdf-ios-android.pdffiller.com/. Open the web app, sign in, and start editing transition of care form.

How do I complete transition of care form on an Android device?

On an Android device, use the pdfFiller mobile app to finish your transition of care form. The program allows you to execute all necessary document management operations, such as adding, editing, and removing text, signing, annotating, and more. You only need a smartphone and an internet connection.

What is transition of care form?

Transition of care form is a document that is used to coordinate the transfer of a patient from one healthcare provider to another, ensuring continuity of care.

Who is required to file transition of care form?

The healthcare providers involved in the transfer of a patient's care are required to file the transition of care form.

How to fill out transition of care form?

To fill out the transition of care form, healthcare providers need to provide relevant information about the patient's medical history, current medications, diagnoses, and any specific care instructions.

What is the purpose of transition of care form?

The purpose of the transition of care form is to ensure that important patient information is properly communicated between healthcare providers during a transfer of care, promoting seamless and coordinated healthcare.

What information must be reported on transition of care form?

Information such as patient demographics, medical history, current medications, diagnoses, allergies, laboratory results, and any specific care instructions must be reported on the transition of care form.