J2H Medical Records Upload
Please choose the document type and then attach a pdf to this form. DO not send multiple patients in the same admission. If you have multiple patients, please hit the final submit button and start over for each patient. Thank you.
Please enter the patient's name for this document.
First Name
Last Name
Please enter the record type for this upload. Only one upload per record type.
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Medical Record
Medication List
Blood Pressure Log
Other
File Upload
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Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you have another type of document for this patient? (If you have other documents for other patients, please hit the submit button below and start over.)
*
No
Yes
Submit
Should be Empty: