Ancillary Medical Report (EC-4 AMR)
Web Submission Process Tutorial
Submitting an EC-4 AMR Form For a Patient
Indicate Who Provided the Services
If the services were provided by someone other than the Board Authorized Health Care Provider select " I actively supervised the health care provider named below who provided these services." and complete the information for the doctor who provided the services.
Otherwise select "I provided the services listed above." and make sure the Board Authorized Health Care Provider section is complete.
