📌👍FMD PATIENT WAITLIST FORM

📌👍PATIENT WAITLIST FORM:

👉PATIENT'S FULL NAME: *

👉BEST EMAIL:

👉CELL PHONE:

👉SPECIFY REASON FOR REQUEST: *

🤔RATE URGENCY LEVEL: *

FOR INTERNAL OFFICE USE ONLY:

This form is only meant to be used by FMD Office Staff for keeping track of patients' scheduling requests and urgency level more efficiently.

Upon submission form will drop info into the Wellness Office Pro's 📌🌐FMD.com = Patient Pipeline where you can easily view the Patient's Urgency Level, Reason, and Date Submitted under the NOTES TAB. Plus, when a time becomes available you can book under BOOK / UPDATE APPOINTMENT TAB to trigger all the TEXT and EMAIL Automated Reminders in the same place.