Physician Follow-Up Instructions

1. Call your primary care physician to schedule an appointment. If you do not have a primary care physician, please refer to our “Do You Have a Doctor” Resource Guide.
2. Once you have scheduled your appointment, remember to bring the attached form or to visit our website, www.ClosingTheHealthGap.org, to download the form. If you are unable to download the form, your doctor can also download the form.
3. Bring the form to your appointment with you or have your doctor download the form and have them complete it.
4. Make sure that your doctor sends the completed form to The Health Gap via e-mail or fax. We will not accept forms that do not come directly from the physician.
5. Receive your $25 gift card!