Patient Consent for Care
$106.24
In stock
Product Code :
MPSBRG-3895/2P
| MPN | 3895/2P |
|---|---|
| Brand | Briggs Health Care |
| Packaging | 100 per pack |
| Size | 8.5 X 11 |
Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details.
Used to obtain patient and/or legal guardian consent for hospice care and to provide supportive evidence that contain required admission elements were reviewed prior to admission to hospice. And to demonstrate receipt of HIPAA notice of privacy practices.
Download a sample today!
Download a sample today!
Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees. This prohibition includes the copying and reproduction of forms, in whole or in part, in any format, including paper and electronic.
Size: 8.5 X 11 Paper: 2-part - white and canary
Print: Black Ink
Punching: 5-holes top and side
Packaging: 100 per pack
Print: Black Ink
Punching: 5-holes top and side
Packaging: 100 per pack
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