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- Click ‘Get Form’ to open the cdph 327 in the editor.
- Begin by entering the Resident Name, Admission Date, and Resident Number at the top of the form. Ensure accuracy as this information is crucial for identification.
- In Section II, identify the parties involved by filling in the names of the Resident and their Representative, if applicable. This section clarifies who is entering into the agreement.
- Proceed to Section III to consent to treatment. Review your rights regarding medical decisions and fill in any necessary details about your Advance Health Care Directive.
- In Section IV, acknowledge your rights as a resident by signing where indicated. Familiarize yourself with the attached 'Resident Bill of Rights' for comprehensive understanding.
- Complete Section V regarding financial arrangements. Specify payment methods and any insurance details required for billing purposes.
- Finally, review all sections for completeness before signing at the end of the document. Ensure that all parties have signed where necessary.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2011 | 4.8 Satisfied (167 Votes) |
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cdph 327 05 11
If your care in our Facility is covered by Medi-Cal or Medicare, no security deposit is required. Page 10. CDPH 327 (ENG) (Rev. 08/2025). State of CaliforniaRead more
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