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Revised 4/14/2023Johns Hopkins Statute COVID-19 Team (JR PACT) Phone 4432872616 Ambulatory JR PACT Enrollment Form Fax 4103672725 ****Patient must have had COVID-19 to enroll**** Email PACT HMI.edu Please

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Individuals who are seeking to enroll in the ambulatory JH PACT program for on-going healthcare services.

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What is ambulatory jh pact enrollment?

Ambulatory jh pact enrollment is the process of enrolling patients into the Johns Hopkins Patient Access Care Team for outpatient services.

Who is required to file ambulatory jh pact enrollment?

Healthcare providers and facilities that offer outpatient services are required to file ambulatory jh pact enrollment.

How to fill out ambulatory jh pact enrollment?

Ambulatory jh pact enrollment can be filled out online through the Johns Hopkins Patient Access Care Team portal or through paper forms provided by the institution.

What is the purpose of ambulatory jh pact enrollment?

The purpose of ambulatory jh pact enrollment is to ensure that patients are properly enrolled in the outpatient care team and that their information is up to date for effective treatment.

What information must be reported on ambulatory jh pact enrollment?

Information such as patient demographics, insurance information, medical history, and primary care provider must be reported on ambulatory jh pact enrollment.

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