Add Patient To Target Group
Instructions
Successful submission of this form will result in addition of a new patient to this campaign.
Please do not use this form to resend a kit to an existing patient.
CASE STATUS
Every patient added to the campaign must choose from one of the following options :
1) Opt In to receive a screening
2) Decline the screening because they are already screened
3) Decline the screening for another reason
If you have spoken to the patient and already have a response, please enter in the response in the form. If marked as Opted In, a kit will immediately be mailed to the patient. If marked as “Please call patient to determine status”, a representative will call the patient to verify if they would like to participate in the campaign.