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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