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Center Street Promenade Anaheim, CA 92805 7147129500 ADDENDUM to Physician Face to Face Encounter Document Examples: Discharge Summary, Progress notes, History and - stjosephhomehealth 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient's name, date of birth (DOB), and start of care (SOC) in the designated fields.
- In section one, check the appropriate boxes for services ordered and provide a detailed explanation for each service based on clinical findings.
- In section two, certify that you have had a face-to-face encounter with the patient by filling in the date of this encounter.
- For section three, detail the reasons why the patient is homebound. Complete all boxes regarding conditions, assistive devices used, and effort required to leave home.
- Ensure you sign and date at the bottom of the form. Print your name and include your primary care physician's name as well.
- Finally, fax the completed form to the provided numbers for submission.
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