NC Onslow Memorial Hospital HIM0001 2014 free printable template
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On slow Memorial Hospital P.O. Box 1358, 317 Western Boulevard Jacksonville, NC 28541-1358 Telephone: (910) 577-2454 Office Hours Mon Fri 8-4.30 Fax: (910) 577-2609 AUTHORIZATION FOR RELEASE OF HEALTH
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How to fill out NC Onslow Memorial Hospital HIM0001
How to fill out NC Onslow Memorial Hospital HIM0001
01
Obtain the HIM0001 form from the NC Onslow Memorial Hospital website or at the hospital's Health Information Management department.
02
Carefully read the instructions provided on the form to understand what information is required.
03
Fill in the patient's personal information, including full name, date of birth, and contact information in the designated sections.
04
Provide details regarding the specific medical records requested, including dates of service and type of records needed.
05
Sign and date the form to certify that the information provided is accurate and that you have the right to request these records.
06
Submit the completed form to the HIM department via mail, fax, or in person as instructed on the form.
Who needs NC Onslow Memorial Hospital HIM0001?
01
Patients who wish to access their medical records from NC Onslow Memorial Hospital.
02
Authorized representatives of patients, such as family members or legal guardians, needing to obtain medical records.
03
Healthcare providers or facilities that require medical records for continuity of care or referral purposes.
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What is NC Onslow Memorial Hospital HIM0001?
NC Onslow Memorial Hospital HIM0001 is a specific document or form used by Onslow Memorial Hospital in North Carolina for health information management purposes.
Who is required to file NC Onslow Memorial Hospital HIM0001?
Healthcare providers, administrators, or any personnel involved in health information management at NC Onslow Memorial Hospital may be required to file NC Onslow Memorial Hospital HIM0001.
How to fill out NC Onslow Memorial Hospital HIM0001?
To fill out NC Onslow Memorial Hospital HIM0001, follow the specific instructions provided with the form, ensuring all required fields are completed accurately and include necessary supporting documentation.
What is the purpose of NC Onslow Memorial Hospital HIM0001?
The purpose of NC Onslow Memorial Hospital HIM0001 is to collect, manage, and report health information effectively within the hospital's health information management system.
What information must be reported on NC Onslow Memorial Hospital HIM0001?
The information that must be reported on NC Onslow Memorial Hospital HIM0001 typically includes patient identification details, treatment information, and any relevant administrative data required by the hospital.
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