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Onsite Health Care for Seniors,
Peace of Mind for Families

(800) 873-0561

Coordinated Care Model – Venn Diagram

Forms

The following forms are available for your convenience:

Enrollment/Registration Packet
Authorization for Release of Medical Records
POLST (Provider Orders for Life Sustaining Treatment)
Advanced Care Planning
HIPAA Notice of Privacy Practices

Contact Us

The Consultative Health and Medicine team is conveniently available at:

Main number:	(800) 873-0561
In a medical emergency:	Dial 911
After hours/weekends:	(800) 873-0561
– Answering service for urgent needs. – Voicemail system for non-urgent needs.
Fax:	(866) 404-2579
Email:	info@consultativehealth.com

Testimonials

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Forms

The following forms are available for your convenience:

Enrollment/Registration Packet
Authorization for Release of Medical Records
POLST (Provider Orders for Life Sustaining Treatment)
Advanced Care Planning
HIPAA Notice of Privacy Practices

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