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Hospital admission request form

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The document is an Admission Request Form for elective medical, surgical, and procedural patients. It outlines the necessary information required for patient admission, including details about the admitting doctor, patient information, insurance coverage, admission specifics, and infection control history. The form emphasizes the need for immediate admissions to be discussed with the Bed Manager and provides contact details for submission.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (81 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What qualifies for hospital admission?

People are admitted to a hospital when they have a serious or life-threatening problem (such as a heart attack). They also may be admitted for less serious disorders that cannot be adequately treated in another place (such as at home or in an outpatient surgery center).

How do I get a direct admit to a hospital?

Typically, this occurs during an office appointment when a physician notices critical symptoms or receives test results that confirm a critical health care scenario. A direct admission is viewed as a higher priority than a planned admission, but not as critical as an emergency admission.

What is admission documentation?

Hospital admission documentation is a decisive factor that pairs the patients condition with the appropriate treatment. Proper documentation outlines the rationale for the admission, linking the patients clinical needs with the prescribed diagnostic or therapeutic measures.

What is a hospital admission form?

A hospital admission form is a document that is used by hospitals to track their patients personal and contact information and demographics, treatment details and to collect patient consent for their planned treatments.

Who writes the initial admission note?

The admitting physician (or designee) is responsible for ongoing care of the patient after accepting responsibility for the patients care whether verbally, by policy, or by writing admission orders, regardless of the patients physical location within the hospital.

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What is the new patient admission note?

An admission note is part of a medical record that documents the patients status (including history and physical examination findings), reasons why the patient is being admitted for inpatient care to a hospital or other facility, and the initial instructions for that patients care.

What is the admission note for hospitals?

Admission notes document the reasons why a patient is being admitted for inpatient care to a hospital or other facility, the patients baseline status, and the initial instructions for that patients care.