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Diagnostics Plus Provider Flag Form

Diagnostics Plus wants to bring you the best service possible. We rely on your opinion of our providers to make sure that you are receiving the best service possible. If you feel there could be improvement or there is a concern about a particular provider please fill out the Provider Flag form and submit it to Diagnostics Plus so we may take care of the issue. Thank you for your time.

Provider Flag Form

Claimant Name:

 

The claimant named above reports to Diagnostics Plus the following problem(s) associated with the diagnostic testing received by the referenced provider.