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INSTRUCTIONS FOR COMPLETING THE REM INTAKE/REFERRAL FORM
PLEASE COMPLETE ALL REQUESTED INFORMATION
Page 1
Referral Source:
Referral source name, address, telephone number and fax number.
Patient
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How to fill out rem program- rare and
How to fill out rem program- rare and
01
Gather all necessary information and paperwork required for the REM program
02
Contact the appropriate agency or organization responsible for the REM program- rare
03
Fill out the application form provided by the agency or organization
04
Submit the completed application form along with any required documentation
Who needs rem program- rare and?
01
Individuals who have a rare disease or condition that qualifies for the REM program
02
Patients who require specialized treatment or therapy that is only available through the REM program
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What is rem program- rare and?
The REM Program is a set of regulations aimed at reducing emissions from industrial sources.
Who is required to file rem program- rare and?
Any industrial facility that meets the criteria set forth in the regulations is required to file the REM Program.
How to fill out rem program- rare and?
The REM Program must be filled out online following the guidelines provided by the regulatory agency.
What is the purpose of rem program- rare and?
The purpose of the REM Program is to monitor and reduce emissions from industrial sources in order to protect the environment.
What information must be reported on rem program- rare and?
The REM Program requires information on the types and amounts of emissions produced by the industrial facility.
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