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Additional Treatment Form Site Name: Date: Patient s Name: Patient s #: Patient s Age: Additional Treatment Needed: (Please check off treatment needed and specify below attach additional sheet if
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What is additional treatment form?
Additional treatment form is a document used to report any extra medical care given to a patient.
Who is required to file additional treatment form?
Healthcare providers or facilities that administer additional treatment to a patient are required to file the form.
How to fill out additional treatment form?
The form should be completed with details of the additional treatment provided, patient information, and signatures from the healthcare provider and the patient.
What is the purpose of additional treatment form?
The purpose of the form is to document any additional medical interventions beyond the regular treatment plan.
What information must be reported on additional treatment form?
Information such as the date of the treatment, type of additional treatment given, any complications, and the outcome should be reported on the form.
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