Instructions for Submitting Your Form


Instructions

Please have these items handy before you start!

* You should fill out any patient/caregiver sections of your form before submitting it to us.

To keep you up-to-date, you will receive two text alerts - one to confirm that your request is in process and one to let you know that your request has been completed.



You will receive text messages similar to these samples:

TEXT MESSAGE EXAMPLE:
MidState Pulmonary is reviewing your request. Will message if any issues. Will message again when form is ready.
Tracking #XXXX-XXXX
TEXT MESSAGE EXAMPLE:
Your Disability/FMLA form is ready. Go to https://krmdr.trimsnet.net/patient/landing/msp. Click green box.
Tracking #XXXX-XXXX



There has been an error processing your request. Technical support has been alerted, however additional information will help solve this issue. Please send some brief comments describing what you were doing:

Thank you for your comments. While waiting for technical support, please logout and log back in before retrying.