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MS-2126 NOTIFICATION OF FACILITY ADMISSION/DISCHARGE Rev 07-07 1. RESIDENT INFORMATION Name: SSN: Date of Birth: Sex: Client ID #: Responsible Person or Agency: Relationship: Responsible Person Address:
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What is notification of facility admission/discharge?
The notification of facility admission/discharge is a form that informs relevant authorities about the admission or discharge of a person from a facility.
Who is required to file notification of facility admission/discharge?
Healthcare facilities or providers are required to file notification of facility admission/discharge.
How to fill out notification of facility admission/discharge?
The notification form can be filled out electronically or manually with the required information about the patient and the facility.
What is the purpose of notification of facility admission/discharge?
The purpose of notification of facility admission/discharge is to ensure proper tracking and monitoring of patient movements for healthcare management purposes.
What information must be reported on notification of facility admission/discharge?
Information such as patient name, facility name, admission/discharge date, reason for admission/discharge, and any relevant medical information must be reported on the form.
Where do I find notification of facility admissiondischarge?
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