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LOS ANGELES UNIFIED SCHOOL DISTRICT Office of Chief Medical Director District Nursing Services Parent Consent and Authorized Healthcare Provider Authorization for GASTROSTOMY FEEDING: BOLUS METHOD
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How to fill out authorization for gastrostomy feeding

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How to fill out authorization for gastrostomy feeding

01
Step 1: Obtain the authorization form for gastrostomy feeding from the healthcare provider or facility.
02
Step 2: Fill out the patient's personal information, including name, date of birth, and medical record number.
03
Step 3: Provide details about the gastrostomy tube, such as the type and size.
04
Step 4: Specify the feeding schedule and formula to be used.
05
Step 5: Include any special instructions or modifications needed for the feeding process.
06
Step 6: Sign and date the authorization form, and have it reviewed and approved by the healthcare provider.

Who needs authorization for gastrostomy feeding?

01
Patients who require gastrostomy feeding as part of their medical treatment plan.
02
Caregivers or family members responsible for administering gastrostomy feeding to a patient.
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Authorization for gastrostomy feeding is a form that allows medical professionals to perform feeding through a tube inserted into the stomach.
The patient's primary care physician or a registered dietitian is typically required to file authorization for gastrostomy feeding.
Authorization for gastrostomy feeding can be filled out by providing the necessary medical information, including the patient's diagnosis, feeding schedule, and specific instructions for feeding.
The purpose of authorization for gastrostomy feeding is to ensure that the patient receives proper nutrition and hydration when they are unable to eat or drink normally.
Information such as the patient's medical history, current medications, allergies, and any complications related to feeding must be reported on the authorization for gastrostomy feeding.
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