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Pediatric Rehabilitation Medicine Department
Inpatient Referral Form(Please complete and fax to 8168551934)
Today's Date:PATIENT INFORMATION
Patients Last name:
Birth date:Middle:First:
Age:Sex:
Preferred
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What is is patient in state?
The term 'is patient in state' refers to whether a patient is currently residing in a particular state or jurisdiction.
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Healthcare providers and facilities are generally required to report a patient's state of residence.
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To fill out the 'is patient in state' field, providers need to indicate whether the patient is currently residing in the state or jurisdiction in question.
What is the purpose of is patient in state?
The purpose of including 'is patient in state' information is to ensure accurate reporting and tracking of patient location for healthcare and administrative purposes.
What information must be reported on is patient in state?
Providers must report whether the patient is currently residing in the state or jurisdiction, or if they have moved to a different location.
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