Get the free Continuity of Care Form - mykporg

CONTINUITY OF CARE REQUEST FORM ATTENTION: UTILIZATION MANAGEMENT OPERATIONS CENTER MEDICAL: FACSIMILE (301) 388 1637 BEHAVIORAL HEALTH: FACSIMILE (301) 3881638 Welcome to Kaiser Permanent: NAME (Please

How to fill out continuity of care form

How to fill out a continuity of care form:

1. Start by reviewing the form and familiarizing yourself with the required information. This may include personal details, contact information, medical history, current medications, and any allergies or special needs.
2. Ensure that you have all the necessary supporting documentation. This may include medical records, test results, and any relevant reports or letters from healthcare providers.
3. Begin by providing your personal details accurately and completely. Include your full name, date of birth, address, phone number, and any other requested information.
4. Fill out the sections related to your medical history. Be thorough and provide as much detail as possible, including any chronic conditions, past surgeries or treatments, and previous hospitalizations.
5. Check whether the form requires you to specify your current medications. If so, list them all, including the dosage and frequency of each medication.
6. If allergies or special needs are requested, make sure to include any known allergies or sensitivities, as well as any physical or mental health conditions that require special care or accommodations.
7. If the form includes a section for emergency contacts or next of kin, provide the necessary contact information for individuals who should be notified in case of a medical emergency.
8. Double-check your entries for accuracy and completeness before submitting the form. It's crucial to ensure that all information is up to date and accurate to guarantee the continuity of care.
9. If necessary, seek assistance from a healthcare professional or hospital staff to clarify any questions or concerns you may have while filling out the form.

Who needs a continuity of care form?

1. Patients who are transitioning between healthcare providers or healthcare settings, such as moving from a hospital to a rehabilitation center or from one physician to another, may require a continuity of care form.
2. Individuals with complex medical conditions, chronic illnesses, or specialized care needs may also need a continuity of care form to ensure that their healthcare information is accurately transferred and that their treatment plan remains consistent.
3. Patients who frequently seek medical care from different providers, such as those receiving treatment from multiple specialists or those who use both traditional and alternative medicine, may find a continuity of care form beneficial in coordinating their healthcare services effectively.

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What is continuity of care form?

Continuity of care form is a document used to ensure that patients receive uninterrupted healthcare services when transitioning between healthcare providers or facilities.

Who is required to file continuity of care form?

Healthcare providers or facilities are required to file continuity of care form when a patient is transitioning to a new provider or facility.

How to fill out continuity of care form?

Continuity of care form can be filled out by providing relevant patient information, medical history, current treatment plan, and contact details for previous and new providers.

What is the purpose of continuity of care form?

The purpose of continuity of care form is to ensure that patients receive seamless and coordinated healthcare services during transitions between providers or facilities.

What information must be reported on continuity of care form?

Information such as patient demographics, medical history, current medications, allergies, treatment plan, and contact details for healthcare providers involved in the transition must be reported on continuity of care form.