Forms and Appendices

Assault and Abuse Reporting Requirements

Employee Acknowledgment of Elder and Dependent Adult Abuse Reporting Obligations

Report of Injury or Condition Resulting From Neglect or Abuse (To a Patient Received From a Licensed Health Facility)

Employee Acknowledgment of Child Abuse and Neglect Reporting Obligations

Request to Withhold Public Release of Information

Authorization for Use or Disclosure of Health Information

Agreement for Facsimile Transmission of Psychiatric Records

Notice to Patient: Procedure for Return of Confiscated Weapon(s)

Notice to Law Enforcement Agency: Release of Person From Hospital From Whom a Firearm or Other Deadly Weapon Was Confiscated

Aftercare Plan

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