Please have the following information available in order to expedite your request.
- Patient's name
- Patients date of birth
- Patient's home address
- Patient's health insurance carrier and contact information
- Insurance individual ID number
- Health insurance group and plan ID
- Medical diagnosis
- Current provider
- Provider telephone number
- Provider email address
- Additional comments/information
The National Heart, Lung and Blood Institute (NIH) has additional helpful resources for healthcare providers treating children with primary ciliary dyskinesia.