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FOR BHF USELL1 2016 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2016)I.DPH License ID Number: Facility

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OSF St. Anthony's Healthcare is a hospital and healthcare organization that provides a range of medical services to patients in the community.

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Patients or their authorized representatives are required to fill out OSF St. Anthony's Healthcare forms when seeking medical treatment or services.

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To fill out OSF St. Anthony's Healthcare forms, patients need to provide their personal and medical information accurately and completely.

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The purpose of OSF St. Anthony's Healthcare forms is to gather information about patients, their medical history, and treatment provided for healthcare records and billing purposes.

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Information such as patient demographics, medical history, insurance information, diagnosis, treatment provided, and consent for medical procedures must be reported on OSF St. Anthony's Healthcare forms.

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