Co-Management Transfer of Care Form

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A tool for the biller, this simple form guarantees all necessary comanagement information is gathered from the surgeon, and also clarifies the optometrists 1st day of post-op period.

 

Category: 
Form
Quantity: 
1 Pad
PEN Member Price: 
$18
List Price: 
$20
Quantity: 
2 Pads
PEN Member Price: 
$27
List Price: 
$30
Quantity: 
4 Pads
PEN Member Price: 
$44
List Price: 
$50
Quantity: 
6 Pads
PEN Member Price: 
$53
List Price: 
$60