Scorecard Exemption Review

Have you had an extenuating circumstance, such as maternity, sick or bereavement leave, or extended trips out of the country? If so, you may qualify for temporary exemption from opening your scorecard. Please complete the form below to request a scorecard review exemption.


Provider Name:

Primary Practice Name:

Month(s) of Scorecard Opening Exemption:

Reason for Requested Exemption::

Address

MyHealth First Network
300 E McBee Ave, Suite 402
Greenville, SC 29601

Phone

1-844-88-MyHFN (844-886-9436)
864-797-7865