Intake Transfer Form: Transfer Center: UI Health Care

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Intake Transfer Screening Form
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Intake Transfer Form

Complete the information on the form legibly and fax it to the UI Hospitals and Clinics Transfer Center at 1-319-467-5546.

Download for your convenience: a transfer checklist.

We look forward to serving you and your patients.

Last modification date: Thu Jan 29 09:10:58 2009
URL: http://www.uihealthcare.com /depts/transfercenter/forms.html