Medicare Shared Savings Program Accountable Care Organizations
NEW PATIENT FORMS (Continued):
STEP 2
After printing all 9 pages, fill in all applicable fields. Print neatly and clearly and sign where indicated.
SUBMIT OPTION 1:
Scan and email the completed pages to: medflrecords@mcmhealthcare.com
SUBMIT OPTION 2:
Fax the completed pages to (561) 774-8576
Important note: be sure to submit the completed packet prior to your appointment.
QUESTIONS? Call us at 855-DOCS-855 (3627)