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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