Take Control of your Medical Information with a MedMemory Personal Health Record

Hotline 1.888.633.6679

Insurance Providers

Insurance Providers

To receive a free copy of any MedMemory health tracking or medical form, send an email to sales@medmemory.com or call us toll free at 1-888-633-6679!

 

To receive all 15 health tracking and medical forms on your MedMemory Health Information Manager

Order your Pill Box, Key Chain, USB Drive Today!

Order your Credit Card USB Today!

Order your Value Model USB Today!

 

The MedMemory Health Information Manager is a Personal Health Record that allows the user to store medical records and other key information on a medical alert designed flash drive. The MedMemory PHR is the future of Medical ID Bracelet and must have for PERS users. Some examples of the templates included with the MedMemory program include Medical Records Release, Power of Attorney, Living Will, Emergency Contacts form, Advance Directives form, Allergy Log, Immunization Log, Diabetes Log, Insurance and Healthcare Provider templates. A must have item for Business Travelers and Caregivers!

Insurance Provider Form

The Insurance Provider form is a convenient template for organization all your Insurance Provider contact and policy information. The Insurance Provider form can be a significant time saver in an emergency or at a routine healthcare visit. An additional benefit of having all your Insurance Providers listed on one simple form is limiting your out of pocket expenses due to not having your secondary insurance information at a healthcare visit.

How To Use The Insurance Provider Form

In addition to the exceptionally user friendly MedMemory program, a MedMemory flash drive purchase includes free Health, Medical, Emergency Contact and Lifestyle templates. All MedMemory templates are designed so that the user only has to use tab key to navigate the template to enter important information.  The object of the Insurance Provider form is to provide the user an easy to use option to attach to the MedMemory program or print out in an emergency or provide at a healthcare visit.

 

Insurance Provider Data Fields

  • Insurance Provider  Name, Type & Address
  • Primary Insured Name
  • Employer Name &Contact Information
  • Contact Representative Name & Phone Number
  • Group Identification & Member Number
  • Insurance Office & Emergency Phone Numbers
  • Office Email & Web Site Addresses

 

To receive all 15 health tracking and medical forms on your MedMemory Health Information Manager

Order your Pill Box, Key Chain, USB Drive Today!

Order your Credit Card USB Today!

Order your Value Model USB Today!

 




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