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My Care Partners Referral Form DATE OF REFERRALURGENCY Low Medium HighReason:PATIENT DETAILS Family name:Given Names:Sex:Date of Birth:MAN:Phone (M):Phone (W):Address: Phone (H): Email: Aboriginal
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How to fill out my care partners referral
How to fill out my care partners referral
01
Contact My Care Partners to request a referral form.
02
Fill out all required information on the referral form accurately.
03
Submit the completed referral form to My Care Partners either online or via mail.
04
Follow up with My Care Partners to ensure they have received and processed your referral.
Who needs my care partners referral?
01
Individuals who require assistance with their healthcare and need guidance in navigating the healthcare system.
02
Those who are looking for a care management team to help coordinate their medical care and services.
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What is my care partners referral?
Your care partners referral is a recommendation or endorsement provided by a healthcare provider to help coordinate and improve your care.
Who is required to file my care partners referral?
Your healthcare provider or care team is required to file your care partners referral.
How to fill out my care partners referral?
To fill out your care partners referral, you need to provide information about your medical history, current health status, and any specific concerns or needs.
What is the purpose of my care partners referral?
The purpose of your care partners referral is to ensure that you receive coordinated and comprehensive care from multiple providers.
What information must be reported on my care partners referral?
Your care partners referral should include information about your medical conditions, treatments, medications, and any other relevant details for your care.
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