Individual Physician Instruction

    Please include as much information as possible regarding your preferred call relay instructions to assist us in handling your important messages efficiently.


    *Name

    Contact Numbers

    Please list in preferred order & indicate if we should only use home number after a certain time.

    1st  Please select one: HomeCellSMS TextSecure Message


    2nd Please select one: HomeCellSMS TextSecure Message


    3rd  Please select one: HomeCellSMS TextSecure Message


    4th: Other

    Type Of Pager Including Pager Company Name

    AlphaNumaric
    Service # or Callers #
    Pager Company:

    Relay Instructions:

    All Medical CallsEmergencyRefillsLabs
    If Emergency Calls Only then please define emergency below:
    Consults

    (Relay as they come in or relay until a certain time then hold next day consults for call out at what time)
    Additional Special Instructions:
    Are You Available For Non PTS After Hours:
    YesNo
    Spam Protection: *
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