Co-Management Transfer of Care Form

You are here

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