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Select One: ? Initial Certification (3 months) ? First Recertification (6 months) ? Yearly Recertification (12 months) ENTERAL NUTRITION REQUEST FORM Georgia Fax to: Toll Free (866) 455-6558 Children

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What is enteral nutrition request form?

The enteral nutrition request form is a document that is used to request enteral nutrition, which is a method of providing nutrition through the gastrointestinal tract when a patient cannot consume food orally.

Who is required to file enteral nutrition request form?

Healthcare professionals, such as doctors or dietitians, are typically responsible for filing the enteral nutrition request form on behalf of their patients.

How to fill out enteral nutrition request form?

To fill out the enteral nutrition request form, you need to provide information such as the patient's medical history, diagnosis, current medications, and specific nutritional requirements. It is recommended to consult with a healthcare professional for assistance in completing the form accurately.

What is the purpose of enteral nutrition request form?

The purpose of the enteral nutrition request form is to ensure that patients who require enteral nutrition receive the necessary support and resources to meet their nutritional needs effectively.

What information must be reported on enteral nutrition request form?

The enteral nutrition request form typically requires information such as patient demographics, medical diagnosis, detailed nutritional requirements, current medications, and any additional supporting documents such as medical reports or lab results.

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