s are escorted to HSD by the Internal Officer. Forms: Medical /Dental Triage Form (See attached) 5) Dental sick call sheet will be turned into the Dental Department for proper scheduling in BEMR according to dental sick call triage guidelines. Pill Line and Medication Refills. 1) Pill line medicati

P. Policy or ID a Name of person(s) covered by this insurance: Pnmary Insurance Company Major Medical Insurance Company Other Insurance (Union, Dental, Vision, etc.) Medicare Medicaid Workers' Compensation Auto Insurance Other insurance Rev. September 2015 Page 3 of 4 EFTA00038440 --- PAGE