Get the free This visit was for a State licensure survey. Facility Number: 012159 ...

Name: Fillable Online This visit was for a State licensure survey. Facility Number: 012159 ... Fax Email Print - pdfFiller
Brand: pdfFiller
Rating: 4.2 (49 reviews)

Get Form

Show details

PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15C000116604/15/2013FORM

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign this visit was for

Edit your this visit was for form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your this visit was for form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit this visit was for online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

To use the professional PDF editor, follow these steps below:

1

Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.

2

Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.

3

Edit this visit was for. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.

4

Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.

With pdfFiller, it's always easy to work with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out this visit was for

01

Gather all necessary information such as personal identification, medical history, and any relevant documents.

02

Arrive at the visit location at the scheduled time.

03

Check in with the receptionist or front desk staff.

04

Provide all required information accurately and honestly during the registration process.

05

Follow any instructions given by the healthcare provider, such as filling out specific forms or questionnaires.

06

Answer all questions to the best of your ability, providing detailed and accurate information.

07

Be prepared to discuss your medical concerns or reasons for the visit.

08

If necessary, provide any necessary samples or undergo any required medical tests.

09

Comply with any additional instructions or recommendations given by the healthcare provider.

10

Thank the healthcare provider and the staff for their assistance and follow up on any further instructions or appointments.

Who needs this visit was for?

01

This visit is for individuals who require medical attention, diagnosis, treatment, or consultation.

02

It can be for patients with specific health concerns, individuals seeking routine check-ups or follow-up visits, or anyone in need of medical advice or guidance.

03

It is beneficial for people of all ages, from children to adults, and for various health conditions or preventive measures.

Fill form : Try Risk Free

Rate the form

4.2

Satisfied

49 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

How do I edit this visit was for straight from my smartphone?

The pdfFiller apps for iOS and Android smartphones are available in the Apple Store and Google Play Store. You may also get the program at https://edit-pdf-ios-android.pdffiller.com/. Open the web app, sign in, and start editing this visit was for.

How do I edit this visit was for on an iOS device?

No, you can't. With the pdfFiller app for iOS, you can edit, share, and sign this visit was for right away. At the Apple Store, you can buy and install it in a matter of seconds. The app is free, but you will need to set up an account if you want to buy a subscription or start a free trial.

Can I edit this visit was for on an Android device?

With the pdfFiller Android app, you can edit, sign, and share this visit was for on your mobile device from any place. All you need is an internet connection to do this. Keep your documents in order from anywhere with the help of the app!

What is this visit was for?

This visit is for conducting an audit.

Who is required to file this visit was for?

The company being audited is required to file this visit.

How to fill out this visit was for?

The visit should be filled out with accurate and detailed information regarding the audit.

What is the purpose of this visit was for?

The purpose of this visit is to ensure compliance with regulations and identify any discrepancies.

What information must be reported on this visit was for?

All financial records and documentation related to the audit must be reported.

Fill out your this visit was for online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now