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PRINTED: 07/06/2017 FORM Approved Jersey Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:BARNETT REHABILITATION AND NURSING CENTER
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How to fill out riverside pediatric day health
How to fill out riverside pediatric day health
01
Obtain the Riverside Pediatric Day Health form from the clinic or download it online.
02
Fill out the patient's personal information, such as name, date of birth, address, and contact details.
03
Provide the child's medical history, including any previous diagnoses, surgeries, or medical conditions.
04
Specify the current medications the child is taking, including dosages and frequency.
05
Indicate any known allergies or sensitivities to medications or substances.
06
Describe the child's dietary restrictions, if any.
07
Provide emergency contact information, including names, relationships, and phone numbers.
08
Sign the form and date it.
09
Submit the completed form to the Riverside Pediatric Day Health clinic or the relevant administrative office.
Who needs riverside pediatric day health?
01
Riverside Pediatric Day Health is suitable for children who require ongoing medical care and monitoring during the day.
02
Patients who have complex medical conditions, require specialized therapies or treatments, or need assistance with daily activities may benefit from Riverside Pediatric Day Health services.
03
Children with chronic illnesses, disabilities, or developmental delays may be eligible for enrollment in the program.
04
Parents or guardians who need support in managing their child's healthcare needs while balancing work or other responsibilities can also consider Riverside Pediatric Day Health.
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