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Operations 21 Refusal Of Care And/Or Transportation Page 1REFUSAL OF CARE AND/OR TRANSPORTATIONAPPROVED:1 Purpose: 1.1 To determine when a person is identified as a patient in the EMS system. 1.2

How to fill out 122 refusal of care

How to fill out 122 refusal of care:

1. Begin by carefully reading and understanding the instructions provided with form 122 refusal of care.
2. Provide accurate personal information such as your full name, contact details, and any identification numbers required.
3. Indicate the type of care or treatment that is being refused by checking the appropriate boxes or providing a clear explanation in the designated section.
4. If applicable, state the reasons for refusing care and provide any supporting documentation or evidence to strengthen your case.
5. Sign and date the form to certify that the information provided is true and accurate to the best of your knowledge.

Who needs 122 refusal of care:

1. Individuals who have been offered or recommended medical care or treatment but wish to decline it.
2. Patients who are of sound mind and fully understand the implications of refusing care.
3. People who have consulted with healthcare professionals and made an informed decision to refuse a particular treatment or procedure.

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What is 122 refusal of care?

The 122 refusal of care refers to a form where a patient can indicate that they are refusing medical treatment or care.

Who is required to file 122 refusal of care?

Any patient who wishes to refuse medical treatment or care is required to file a 122 refusal of care form.

How to fill out 122 refusal of care?

To fill out a 122 refusal of care form, the patient must provide their personal information, state their refusal of care, and sign the form.

What is the purpose of 122 refusal of care?

The purpose of the 122 refusal of care is to document a patient's decision to refuse medical treatment or care.

What information must be reported on 122 refusal of care?

The 122 refusal of care form must include the patient's name, date of birth, contact information, specific care refused, and the reason for refusal.