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)
PR 16-4 Time Extension for Compliance with Subpoena California Health Information Privacy Manual
HS 9 Timeline for 23-Day Termination Track California Hospital Survey Manual
HS 8 Timeline for 90-Day Termination Track California Hospital Survey Manual
9-2 Transfer Summary (Transfer From Acute Hospital to SNF) Consent Manual
4-1 Transfusion Information Form Consent Manual
Appendix 9-B Types of MCPs and MHPs Consent Manual
HS 4 Unusual Occurrences Reporting Requirement California Hospital Survey Manual
6-3 Warrantless Medical Search Request by Peace Officer (When Subject Refuses to Consent) Consent Manual
WVP 1-A Workplace Violence Incident Case Number Assignment Form Healthcare Workplace Violence Prevention