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General
Before providing any patient information, there MUST BE A WRITTEN RELEASE FROM THE PATIENT
Instructions for Completion of Insurance Forms
When requests to complete insurance forms are received, please:
Fill in our contact information: Addresses, phones, fax, etc.
Fill in the visit dates if requested. If there is not enough space, start with the most recent and work your way back
Print out all of the requested information. E.g. Consults, pathology or OR reports
Pass along to the Urologist for Signature and final review - DO NOT SEND OUT WITHOUT THE UROLOGIST HAVING REVIEWED THE REQUEST
Fees
Form Type | Krahn | Poon | Rapoport | Taylor |
---|---|---|---|---|
Insurance | ||||
Medical Record - Physician | ||||
Medical Record - Lawyer | ||||
Medical Record - Patient |
Instructions for Completion of Absences/Return to Work
Procedure | Standard Length of Time Off | Other (Activities, etc.) |
---|---|---|
Radical Prostatectomy | 6 Weeks |