Healthcare Documents

This file contains the HIPAA Training Acknowledgment and Certification form. It is used to certify that an individual has attended the required HIPAA training session. The form ensures compliance with HIPAA policies for handling protected health information.

The DMAS-90A form is used for recording skilled respite care provided by RN/LPN services. It includes patient information, medical assessments, and care details. Proper completion of this form ensures accurate documentation and compliance with state and federal regulations.

This document provides details and instructions for the Alcon Rewards Program 2024. It includes rebate information, how to claim rewards, and program terms. Alcon users can save up to $225 in rewards.

This file is a Therapeutic Phlebotomy Order form from LifeSouth Community Blood Centers. It includes instructions for physicians on how to complete the form, as well as patient information and order details. The form must be completed by a physician or advanced practice provider and faxed to LifeSouth.

This form is used for referring patients for Immunoglobulin therapy at Optum Infusion Pharmacy. It includes patient information, insurance details, and physician's orders. Ensure all required fields are filled accurately before submission.

The 701S Screening Form by the Florida Department of Elder Affairs is used for assessing individual health, living situations, caregiver involvement, and income status. It collects necessary details such as personal information, social security number, and Medicaid number. The form ensures that individuals receive appropriate care services and programs.

This file provides sizing charts for T.E.D™ Anti-Embolism Stockings, Kendall SCD™ Compression Sleeves, and A-V Impulse™ Foot Compression System. It includes detailed measuring instructions for both thigh length and knee length stockings. Use this file to ensure proper fit and reduce the risk of deep vein thrombosis.

This file is used by NHS Bursary students to claim travel and dual accommodation expenses. It includes fields for personal details, travel methods, and practice placement info. The file should be submitted to your university within nine months of your practice placement.

This is a vision examination report required by the Arizona Department of Transportation Motor Vehicle Division (ADOT MVD). It includes a standard vision report, a comprehensive medical eye report, and instructions for both physicians and drivers. This form is necessary for drivers to meet the vision requirements for a driver's license.

This file is for parents/guardians who wish to decline vaccinations for their child. It includes information on the risks and implications of not vaccinating. Signed by both parent/guardian and healthcare provider.

This form is used for the review of previously adjudicated claims for BlueCross BlueShield of Illinois Medicare Advantage. Ensure not to attach original claims to this form, and submit only one form per patient. Required information must be filled out for review.

This file provides a detailed guide on how to use the 2023 Outpatient E/M Audit Tool. It includes instructions for documentation, coding guidelines, and MDM elements. Ideal for healthcare providers and auditors.