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Patient Forms

After completing the form(s), you may fax, mail, or email the form(s) to Advanced Cardio Services™ (ACS). If you choose to email the form(s), please note that ACS cannot assure the safe delivery or security of your email transmission. Please be aware that there is a risk that your protected health information (PHI) could be read, viewed, or otherwise accessed by a third party. If you elect to send a form through email, you will have assumed the security risk of emailing the forms to us.

Reminder: There is no requirement to send the forms via email.

  • Email:
  • Fax: 844.700.3484
  • Mailing Address: 2001 N.E. 46th Street, Suite 152, Kansas City, MO 64116


ACS® Patient Enrollment Form

When you identify a new PT/INR Self-Testing patient, complete the Patient Enrollment Form. View, print, or save the Patient Enrollment Form.


ACS® Patient Management Info

Clinical benefits and proven effects of weekly self-testing.


Time in Therapeutic Range

ACS® patients are within prescribed therapeutic range 86% of the time.


Checking Your PT/INR

As a warfarin patient, you now have the option of checking your PT/INR at home, anytime.


PT/INR Self-Testing

Is it right for you? Take charge of your INR testing today!


Sample Patient Result

A sample of the report you will receive of patient INR results.


CPT Code

Code for Anticoagulation Monitoring, in office vs. home testing services.



Warfarin patient management solution for point-of-care, lab drawn, home drawn and self-testing patients.


Digital Ordering/E-Prescribing

Prefer to order everything electronically. Place your next INR order via Parachute today!


mdINR® App Instructions

Quick start user guide for patient reporting of weekly INR results via our mdINR® app.


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Choose ACS® Today

ACS is committed to assisting individuals on long-term warfarin therapy with a comprehensive anticoagulation program that allows patients to self-test for INR from the comfort of home. ACS provides industry-leading products, dependable services, and ongoing support that helps patients every step of the way.

If you are interested in learning more about how you can self-test for INR from the comfort and safety of home, contact us today.

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