At QAS, we strive to provide the tools that you need for effective management of INR testing. Due to demand, we have created easy to use patient forms for INR self-testing. You can complete the prescription form, letter of medical necessity and patient information sheet and print them directly from the website.
- STEP 1
Click one of the links below to begin downloading the form. When the form opens click in the various fields to enter your patient information. A cursor will appear and you can key in the information; then press tab to go to the next entry field.
- STEP 2
After you complete each form, print it for the physician and patient signatures. To ensure a timely result for everyone, please make sure the forms are complete.
- STEP 3
You can fax the forms to your QAS representative or to our main fax line 407-563-2861.
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ProTime Rx and Letter of Medical Necessity |
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Protime Patient Information Sheet |
