Get the free Health Management Department Referral Form - CalOptima
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Health Education and Disease Management Department Referral Form Fax form to: 17143383127 or Email to: health promotions cal optima.org Call for questions: 17142468895 For printable health education
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How to fill out health management department referral
How to fill out health management department referral
01
Obtain the referral form from the health management department.
02
Fill out your personal information, such as your name, date of birth, and contact details.
03
Provide the details of the health management program or service you are seeking a referral for.
04
Indicate the reasons or medical conditions that necessitate the need for the referral.
05
If applicable, include any relevant medical history or previous treatments you have undergone.
06
Ensure all the necessary fields are completed accurately and legibly.
07
Review the completed referral form to ensure all information is correct and complete.
08
Sign and date the referral form.
09
Submit the filled-out referral form to the health management department following their specified process.
Who needs health management department referral?
01
Anyone who requires access to specific health management programs or services provided by the health management department may need a referral. This includes individuals with chronic conditions, complex medical needs, or individuals who would benefit from specialized care and interventions provided by the department. The specific criteria for needing a referral may vary based on the policies and guidelines of the health management department.
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