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KANSAS BURN INJURY REPORTING SYSTEM This form must be completed for 2nd and 3rd degree burns involving 20 percent or more of the patients body2023 Name of Facility: Address of Facility Patients Name
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The form centerkansas burn injury is a documentation used to report incidents of burn injuries occurring in Kansas, typically for legal or insurance purposes.
Individuals or entities involved in an incident that resulted in a burn injury, such as victims, healthcare providers, or legal representatives, are required to file this form.
To fill out the form, provide accurate personal details of the injured party, details of the incident, medical treatment received, and any other required documentation.
The purpose of the form is to formally document the occurrence of a burn injury for the purposes of legal claims, insurance coverage, and statistical data collection.
Information such as personal identification details of the injured party, description of the burn injury, circumstances of the incident, and medical treatment received must be reported.
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