Attending Physician Chart Note Print for one page form to add to hospital chart. EPSDT Referral Form (Medicaid) (.pdf) Requires Adobe Acrobat Reader plugin to open. Best quality. EPSDT Referral Form (Medicaid) (.html) Set margins under Page Setup to 0.25 inches top, bottom, and sides prior to printing. Blank Call Schedule Word Document. Download to your harddrive and open in Word.