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Care Coordination and Care Management Request Form Please complete all fields and securely email to ohsuhscareteam@ohsu.edu Ensure that all information is provided as incomplete requests will not
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How to fill out health related service hrs

01
Start by obtaining the necessary forms from the health related service provider.
02
Fill out personal information including name, address, contact details, and date of service.
03
Specify the type of service received and the duration of the service.
04
Include any additional notes or comments about the service provided.
05
Sign and date the form before submitting it to the appropriate department for approval.

Who needs health related service hrs?

01
Individuals who are required to report their health related service hours as part of a volunteer program.
02
Students in health-related fields who need to document their practical experience for certification or licensure.
03
Professionals who need to keep track of their continuing education credits in the health sector.
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Health related service hours are the hours spent providing healthcare services or related activities.
Healthcare providers and organizations are required to file health related service hours.
Health related service hours can be filled out by documenting the hours spent on healthcare services and submitting the information to the relevant authorities.
The purpose of health related service hours is to track and report the amount of time spent on providing healthcare services and activities.
Information such as the date, time spent, type of service provided, and the individual or organization receiving the service must be reported on health related service hours.
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