JPOCSC Medical DayCare Feferral for Iron Infusion or Phlebotomy

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  • Create Date May 23, 2023
  • Last Updated May 22, 2023

JPOCSC Medical DayCare Feferral for Iron Infusion or Phlebotomy

This is an updated version of the coversheet and MDC request specific to the Jim Pattison site. The changes are VERY minor compared to the 2015 background.  In addition, there is no place to add details for your iron infusion instructions.  That requires another eForm: "FHA Parenteral Iron PPO".

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JPOCSC290Medical290DayCare.zipDownload