Care Co-Ordination

Please enter information on the fields below to receive sample real-time communications from the PatientBond application. Note that these sample communications are meant for demo only and actual communications processes and content are fully configurable and comply with all HIPAA and PHI regulations
Patient Name
Parent Name
Email Preference
Yes
No
Parent Email Address
Voicemail Preference
Yes
No
Parent Phone Number
SMS Preference
Yes
No
Parent Cell Number
Check if same as Parent Phone No.
Diagnosis
Pediatric Ashthma
Diabetes
Physician Name
Appointment Date/Time
RN Care Coordinator
RN Phone Number
RN Follow up Date
Pulmonologist Name
Pulmonologist Phone Number
Submit
PatientBond Communications Platform