CASE MANAGER/REFERRING AGENCY INFORMATION
Instructions for completing New Patient Information Form (Word document with form fields).
1. Double click on link to open download instructions.
2. Choose "save". Select file on your desktop to save file.
3. When you open file to edit from desktop, you will tab from field to field to complete all information on the form.
4. Once complete, save document in file on your hard drive. Save under patient's name and date of submission. (Example: "John Smith application - 8-29-07" No *, / or &.)
5. Print completed document for patient's signatures.
If you have any questions about how to use this form, send e-mail to Imagery Marketing.