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您可以在东部时间上午 8:30 至傍晚 6:00 期间拨打电话,或通过电子邮件的方式联系我们的专员。请填写以下有关详情,以使用本联系表单。除了提供您的姓名以及我们可以联系您的电子邮件地址之外,请从下拉条件中选择并留下明确的信息,以便我们能够及时适当地作出回应。我们会在两个工作日内发送电子邮件回应。

[[[["field7","contains","Potential Patient"],["field7","contains","Other"],["field7","contains","Referral Source"]],[["email_to",null,"OC-ContactUsAtOptionCare@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"]],"or"],[[["field7","contains","Billing Inquiry"]],[["email_to",null,"OC-PP-ResolutionTeam@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"],["email_to",null,"mervin1387@gmail.com"],["email_to",null,"bbmj4872@gmail.com"],["email_to",null,"meghan.ervin@antennagroup.com"]],"and"],[[["field7","contains","Human Resources Inquiry"]],[["email_to",null,"HROPS@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"],["email_to",null,"mervin1387@gmail.com"],["email_to",null,"bbmj4872@gmail.com"]],"and"],[[["field7","contains","Business Outreach"]],[["email_to",null,"BusnessDevelopment@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"],["email_to",null,"mervin1387@gmail.com"],["email_to",null,"bbmj4872@gmail.com"]],"and"],[[["field7","contains","Enteral Refill Request"]],[["hide_fields","field8","courtney.jurick@optioncare.com"],["email_to",null,"EnteralRefill@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"]],"and"],[[["field37","equal_to","Yes"]],[["show_fields","field38"]],"and"],[[["field39","equal_to","Yes"]],[["show_fields","field40"]],"and"],[[["field41","equal_to","Yes"]],[["show_fields","field42"]],"and"],[[["field43","equal_to","Yes"]],[["show_fields","field44"]],"and"],[[["field45","equal_to","Yes"]],[["show_fields","field48"]],"and"],[[["field47","equal_to","Yes"]],[["show_fields","field46"]],"and"],[[["field51","equal_to","Yes"]],[["show_fields","field52"]],"and"],[[["field7","contains","Enteral Refill Request"]],[["show_fields","field55,field56,field37,field39,field41,field43,field45,field47,field49,field50,field51,field53,field57"]],"and"],[[["field53","equal_to","Yes"]],[["show_fields","field54"]],"and"],[[["field7","contains","Patient Service Issue"]],[["email_to",null,"CustomerFeedback@optioncare.com"],["email_to",null,"courtney.jurick@optioncare.com"]],"and"]]
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名字名字
姓氏姓氏
电话号码电话号码
城市城市
患者名字
患者姓氏
与患者的关系
您当前的地址是否有任何变动?
如果是,请详细说明:
您的保险是否有任何变动?
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您的主治医生是否有任何变动?
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您在过去 30 天内是否曾住院治疗?
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您的营养疗法是否有任何变动?
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输入患者体重(单位:磅)。
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您是否有与供送泵或喂食相关的问题?
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