Get the free Intermacs Transfer Form - UAB

7/22/2019TransferIntermacsTransfer Form Transferred Care to another hospital Patient followed exclusively at another hospitals Notate transferred care MM/DD/YYYYSTUnknown1 of 1

How to fill out intermacs transfer form

How to fill out intermacs transfer form

1. To fill out the INTERMACS transfer form, follow these steps:
2. Start by entering the patient's demographic information, including name, date of birth, and contact details.
3. Specify the reason for the transfer, such as a change in medical facility or need for specialized care.
4. Provide details about the current heart assist device, including the make, model, and implantation date.
5. Include any relevant medical history, such as previous surgeries or complications.
6. Indicate the desired destination for the transfer and contact information of the receiving facility.
7. Ensure all sections of the form are thoroughly completed, including any necessary signatures.
8. Review the form for accuracy and completeness before submitting it to the appropriate authority.

Who needs intermacs transfer form?

1. The INTERMACS transfer form is needed by patients who require a transfer from one medical facility to another for advanced heart failure care.
2. It is also used when a patient needs to change their heart assist device or when specialized care is needed and cannot be provided at the current facility.
3. Healthcare professionals involved in the transfer process may also require the form to ensure smooth coordination and continuity of care.

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What is intermacs transfer form?

The INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) transfer form is a document used to report the transfer of patients who are receiving mechanical circulatory support, ensuring proper documentation and data collection for ongoing research and patient care.

Who is required to file intermacs transfer form?

Healthcare providers and institutions that manage patients on mechanical circulatory support are required to file the INTERMACS transfer form.

How to fill out intermacs transfer form?

To fill out the INTERMACS transfer form, clinicians must provide patient demographics, clinical status, device details, and discharge information accurately and completely, following the guidelines provided by INTERMACS.

What is the purpose of intermacs transfer form?

The purpose of the INTERMACS transfer form is to ensure accurate data collection on patients receiving mechanical circulatory support, facilitate patient tracking, and improve outcomes through research and analysis.

What information must be reported on intermacs transfer form?

Information that must be reported on the INTERMACS transfer form includes patient identifiers, clinical status indicators, device type, complications, and transfer details.