CA Stanford Health Care Form 15-79-1 2009 free printable template

Please send request to: Stanford Hospital and Clinics (SHE) HIMS Dept. Rm HC029 MC: 5202 300 Pasteur Drive, Stanford, CA 94305 5200 Phone: (650) 7235721 Fax: (650) 7259821STANFORD HOSPITAL and CLINICS

How to fill out CA Stanford Health Care Form 15-79-1

How to fill out CA Stanford Health Care Form 15-79-1

1. Obtain the CA Stanford Health Care Form 15-79-1 from the official Stanford Health Care website or request it from their office.
2. Read the instructions provided on the form carefully to understand the required information.
3. Fill in your personal details including your name, address, and contact information in the designated sections.
4. Provide information about your healthcare provider, including their name and contact information.
5. Specify the reason for completing the form, following the guidelines given in the form.
6. Sign and date the form at the bottom to authenticate your submission.
7. Submit the completed form to the appropriate department as indicated in the instructions.

Who needs CA Stanford Health Care Form 15-79-1?

1. Individuals seeking healthcare services at CA Stanford Health Care who need to provide consent or authorizations.
2. Patients requiring documentation for insurance claims related to care provided at Stanford Health Care.
3. Caregivers or family members of patients who need to manage healthcare decisions or access patient information.

People Also Ask about

Is Stanford Health Care the same as Stanford hospital?

Although the leadership of Stanford Health Care and Stanford University work in close partnership, the hospital and university are separate legal entities.

Is Stanford Medicine the same as Stanford University?

Stanford School of Medicine is a part of Stanford University, one of the world's leading teaching and research universities.

What is the name of Stanford hospital?

Stanford University Medical Center is a medical complex which includes Stanford Health Care and Stanford Children's Health.

How do I get my medical records from Stanford hospital?

As a patient, you or your legal representative may obtain a copy of your medical records or have copies of your medical records sent to another person or facility. You can fill out the request for your records online by logging in to MyHealth on the web and completing the form under My Medical Records>Request Records.

Where do I get my birth certificate if I was born in Stanford hospital?

Birth certificates can be requested directly by calling Alameda County Offices at 510-272-6362.

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What is CA Stanford Health Care Form 15-79-1?

CA Stanford Health Care Form 15-79-1 is a specific form used for reporting health care data and information relevant to Stanford Health Care in California.

Who is required to file CA Stanford Health Care Form 15-79-1?

Health care providers affiliated with Stanford Health Care that are required to report specific data and information concerning patient care and services.

How to fill out CA Stanford Health Care Form 15-79-1?

To fill out CA Stanford Health Care Form 15-79-1, follow the instructions provided on the form, ensuring all required fields are completed accurately with the necessary data related to patient care.

What is the purpose of CA Stanford Health Care Form 15-79-1?

The purpose of CA Stanford Health Care Form 15-79-1 is to collect and report health care data to improve patient care, ensure compliance with state regulations, and enhance health care services.

What information must be reported on CA Stanford Health Care Form 15-79-1?

Information that must be reported includes patient demographics, types of services provided, outcomes of care, and other relevant health care data as specified in the form guidelines.