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PAGE 1 OF 3Fairview Health ServicesINFECTIOUS DISEASE
Delineation of PrivilegesApplicants Name (please print):
Must be an MD/DO and have completed Threshold Criteria listed in the individual privilege
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What is health statementrelease worker?
Health statementrelease worker is a form that workers are required to fill out to release their health information to the company or organization they work for.
Who is required to file health statementrelease worker?
All workers are required to file a health statementrelease worker form.
How to fill out health statementrelease worker?
To fill out a health statementrelease worker form, workers need to provide their personal health information and sign the release consent.
What is the purpose of health statementrelease worker?
The purpose of health statementrelease worker is to allow employers to have access to their employees' health information for work-related purposes.
What information must be reported on health statementrelease worker?
Information such as medical history, current health conditions, medications, and any other relevant health information must be reported on a health statementrelease worker form.
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