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FormsEmployment OpportunitiesEmployment Application - Apllication can be printed and faxed to 908-813-3002, or dropped off at any location, or can be e-mailed back to bmiller@bachs.com. BACHS is an equal opportunity employer. Patient FormsCustomer Complaint Form - This form is to be used for patients, as well as employees that have received patient complaints and inquiries about their account. ALL complaints are classified into one of 6 categories: 1. Delay of Service/Timeliness 2. Quality of Service 3. Product Issues/Defects 4. Communication Issues 5. Staffing Issues/Attitudes 6. Billing & Reimbursement The contact is President/CEO Bob Miller at 908-813-3003 and he can be contacted at any time. Informed Consent - Consent form for patient and provider to agree on insurance terms prior to a sale or rental when there is no reimbursement available. Patient Master Demographics - Patient, families and referrals can fill out this form and either bring it into any of our locations, FAX it to 908-813-3002 Doing this in advance will save time and overall frustration in getting the correct data to proceed with your case. Refusal of Service - Patients can use this form to discontinue services without physician approval or advice. ONLY patients or their directly authorized representatives may sign this form. | |||
Two Convenient Locations
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