Clinical Communication Preferences

 

Please select and enter necessary information for clinical information your
facility expects to receive. 
First and Last Name  *Practice Name  *Providers Requesting Updates to Clinical Communications  *Practice Address  *Practice Phone Number  *Practice Email  *Please provide us your default fax to receive clinical reports and results.  *Do you have a Valley Children's Epic CareLink account?  *

Summary Notification

Valley Children's provides the following reports to all referring providers
via fax unless otherwise specified. Below, please check the box next to the
summaries/reports you would like to continue receiving via fax.
Summaries/reports left unchecked indicate you no longer wish to receive
the information by fax. 
Select boxes below.