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PERMISSION FOR VERBAL COMMUNICATIONS (To be used only by patients 19 years of age and older) (Print name of patient)(Birth date of patient) (Street address of patient)(City, state, zip code) (Phone

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What is to be used only?

To be used only means the item is intended for only a specific purpose and should not be used for any other reason.

Who is required to file to be used only?

Any individual or organization intending to restrict the use of an item to a specific purpose may be required to file a 'to be used only' form.

How to fill out to be used only?

To fill out a 'to be used only' form, one must clearly specify the item, state the intended purpose, and provide any relevant supporting documentation.

What is the purpose of to be used only?

The purpose of 'to be used only' is to ensure that an item is used only for its designated purpose and to prevent misuse or unauthorized use.

What information must be reported on to be used only?

Information such as the item description, purpose of use, restrictions on use, and any supporting documentation must be reported on a 'to be used only' form.

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