Forms and Appendices

Hospitals that are members of the California Hospital Association may use these model forms, appendices, signs and handouts as templates in developing their own forms, signs and handouts.

CHA forms are updated periodically. The current version of CHA forms are downloadable from this page, and may or may not match the forms found in CHA’s printed manuals. The date on which each form was last updated appears in the lower right corner of each form.

Hospitals that are members of the California Hospital Association may use these model forms, appendices, signs and handouts as templates in developing their own forms, signs and handouts.

This content is restricted to members.

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Showing 201 - 209 of 209 results

Form Number Form Name Associated Manual(s)
Appendix M An Explanation of the Scope of RN Practice Including Standardized Procedures EMTALA Manual
14-1 Agreement for Facsimile Transmission of Psychiatric Records Consent Manual
13-3 Aftercare Plan Consent Manual
PR 16-5 Affidavit of Custodian of Medical Records to Accompany Copies of Records California Health Information Privacy Manual
12-7 Advisement of Rights – Involuntary Patient Consent Manual
3-1 Advance Health Care Directive Consent Manual
PR 1-A Acronyms California Health Information Privacy Manual
10-2 Acknowledgment of Release of a Minor Consent Manual
HC 1-A Acknowledgment of Receipt of Hospital Compliance Plan Mental Health Law Manual, Hospital Compliance Manual