Atrium Health Referral Forms

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Refer a Patient Atrium Health

(2 days ago) WEBPlease be ready to share the patient’s full name, date of birth and diagnosis. Atrium Health Levine Cancer. 980-442-2000. Sanger Heart & Vascular Institute. 877-999-7484. …

https://atriumhealth.org/for-providers/refer-patient

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REQUEST FOR TREATMENT AND AUTHORIZATION FORM

(Just Now) WEBAtrium Health charges the patient incurs in accordance with Atrium Health’s regular rates and terms as set forth in the “chargemaster” in effect at the time of treatment that …

https://cdn.atriumhealth.org/-/media/chs/files/for-patients-visitors/registration-forms/current-ah-consent-to-treatment-and-authorization.pdf?rev=e399bcf0c91848a2827f369d583cdcb4&hash=DFF554712AF196CBDD36DA813CB109EA

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New Patient Referral Form - Atrium Health

(6 days ago) WEBNew Patient Referral Form Please fax the completed form and requested documentation to 704-667-9239. Mail all discs to Attn: SHVI, 9401 Arrowpoint Blvd., Charlotte, NC …

https://cdn.atriumhealth.org/-/media/chs/files/medical-services/specialty-care/heart-care/233119-cardio-referral-form-pdf-final-32923.pdf?rev=46469c29d4c24da2887cc73ed45fb254&hash=44816BBB8B37CE6DBB3B188F29F22405

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For Patients and Visitors Atrium Health

(6 days ago) WEBSome items you can even take care of before your visit to save time. Find answers to questions regarding pre-registration, health insurance and general information. Talk to a …

https://atriumhealth.org/for-patients-visitors

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Contact Us Atrium Health

(5 days ago) WEBCall or chat with us online. There are many ways to contact us, and we'd like to hear from you. Call us at 800-821-1535 to ask a question or request more information. Call us at …

https://atriumhealth.org/contact-us

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TRANSPLANT REFERRAL FORM - Atrium Health

(4 days ago) WEBAtrium Health Transplant Center, a facility of Carolinas Medical Center PO Box 32861, Charlotte, NC 28232 Phone: 704-355-3855; 704-355-6649 Fax: 704-446-4876; 704-446 …

https://cdn.atriumhealth.org/-/media/chs/files/medical-services/specialty-care/transplant/kidney-pancreas-transplant/living-donors-referrals/atrium-healthcmc-kidney-transplant-referral-form5182021-1min.pdf?rev=f9f108a432a34da7be3bcf503e10e7be&hash=149895EB28040DC669D82D1F806CA2E7

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ATRIUM HEALTH INFUSION CENTERS

(4 days ago) WEBATRIUM HEALTH INFUSION CENTERS Referral Form (Sections A-D MUST BE COMPLETED, Submit with Medication Order) FAX TO 704-468-3401 See page 2 for a …

https://cdn.atriumhealth.org/-/media/chs/files/medical-services/specialty-care/other/infusion/referral-form-min.pdf?rev=460afe0e44b44e0f840ed0b52fe44107&hash=EEF676DFDC15DA9E7209705EE2C5BA15

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Atrium Health: World-Class Health Care Find a Doctor

(4 days ago) WEBAtrium Health provides healthcare, hope and healing at more than 1,400 care locations and 40 hospitals across NC, SC, GA and AL. With over 65,000 employees, Atrium …

http://atriumhealth.org/

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Medical Records Atrium Health

(2 days ago) WEBSubmit your completed forms via one of the options below: Mail . Atrium Health Corporate Health Information Management Release of Information PO Box 32861 Charlotte, NC …

https://atriumhealth.org/for-patients-visitors/medical-records

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Patient Forms Levine’s Children’s Atrium Health

(7 days ago) WEBPediatric Patient Forms. From infants and toddlers to children and teens, every child deserves excellent, comprehensive care. To help us deliver the best care, we need to …

https://atriumhealth.org/medical-services/childrens-services/childrens-primary-care/patient-forms

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Potential Living Donor Referral Form - Atrium Health

(1 days ago) WEBPlease list your medications and their dosages: (Use additional paper, if necessary) Please list all your surgeries and dates they occurred: (Use additional paper, if necessary)

https://cdn.atriumhealth.org/-/media/chs/files/medical-services/specialty-care/transplant/kidney-pancreas-transplant/fillable_2020-kidney-living-donor-referral-form-min.pdf?rev=29b4992fa3d84c078c2f41b637aa1e5b&hash=4E87C3087A15D684AE01A1745CACAA04

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Find a Doctor Near Me Charlotte, NC & SC Atrium Health

(8 days ago) WEBEmployee Assistance Program Services. With online doctor appointments and physicians in Charlotte, NC & SC, Atrium Health makes it easy for you to find care close to home. …

https://atriumhealth.org/find-a-doctor

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For Providers Atrium Health

(8 days ago) WEBAt Atrium Health, we partner with you every step of the way. Together, we can provide truly patient-centered care, backed by our nationally recognized experts, exceptional …

https://atriumhealth.org/for-providers

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TRANSPLANT REFERRAL FORM - Atrium Health

(1 days ago) WEBAtrium Health Transplant Center, a facility of Carolinas Medical Center PO Box 32861, Charlotte, NC 28232 Phone: 800-562-5752; 704-355-3855 Fax: 704-446-4876; 704-446 …

https://atriumhealth.org/-/media/chs/files/medical-services/specialty-care/transplant/kidney-pancreas-transplant/living-donors-referrals/kidneypancreas-referral-forms_final_2020-min.pdf?la=en&hash=99CA61682EAD1A3A618E0BA545C465EF8C689084

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ORDER FOR CAROLINAS REHABILITATION - Atrium Health

(5 days ago) WEBORDER FOR CAROLINAS REHABILITATION One Patient Name _____ DOB _____ Phone Number _____ Alternate Phone Number _____

https://atriumhealth.org/-/media/documents/rehabilitation/rehabilitation-outpatient-therapy-referral-form.pdf?la=en&hash=BE1E007CAEB9F5BA179DD7E7DF889F5B1837DF07

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Provider Referral Form - Atrium Health

(5 days ago) WEBProvider Referral Form. Referring Teammate / Provider’s Name Referral / Candidate’s Name Referral Type Referral / Candidate’s Phone Number Referral / …

https://atriumhealth.org/newproviderportal/chs-medical-group/physician-acp-recruitment-rewards-program/provider-referral-form

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New pt referral form-Liver 2 - Atrium Health

(6 days ago) WEBCenter for Liver Disease Referral Form Attn: New Referral Coordinator Phone: (704) 355-6924 Fax: (704) 355-6998 Dr. Mark Russo and Greg Conner, PA After completion of the …

https://atriumhealth.org/documents/cmc/referralformlivercenter.pdf

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HEALTH REQUEST FOR TREATMENT AND AUTHORIZATION …

(5 days ago) WEBAtrium Health – 10/2018 HEALTH REQUEST FOR TREATMENT AND AUTHORIZATION FORM REQUEST FOR TREATMENT. The Charlotte-Mecklenburg Hospital Authority …

https://atriumhealth.org/-/media/files/registration-forms/hospital-consent-treatment-form-and-authorization-10-2018.pdf?la=en&hash=18A0496220549D929BF46904E9D9DCAEDDBC81B8

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Infusion Services Specialty Care Atrium Health

(5 days ago) WEBTo make a referral to an Atrium Health Infusion location, please complete the below referral and medication order forms and submit them by fax to 704-468-3401. For …

https://atriumhealth.org/medical-services/specialty-care/other-specialty-care-services/infusion

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Outpatient Referral Form - Atrium Health

(6 days ago) WEBDisease Management Health Promotion @ Carolinas HealthCare System Stanly 313 Yadkin Street Albemarle, NC 28001 Phone 980-323-4189 Fax: 980-323-5162 The …

https://atriumhealth.org/-/media/files/diabetes/chs-diabetes-outpatient-referral-form-updated-oct-2016.pdf

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