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How to use or fill out Placement Patient Information Form - urmc rochester with our platform

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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient's name and date at the top of the form. Ensure accuracy as this information is crucial for identification.
Fill in the social worker's name and phone number, along with the unit details. This helps streamline communication regarding patient placement.
Indicate the OBS status by selecting from options such as Full Inpatient Admit or Previous Hospital Stay within last 30 days.
Specify the expected discharge date and disposition by choosing from options like HRF, SNF Long Term, or Home. This section is vital for planning post-discharge care.
List facility choices in order of preference (1-10). Mark your selections clearly to ensure proper placement according to preferences.
Complete any additional fields related to special needs, such as equipment requirements or medical conditions, ensuring all relevant information is provided.

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Versions	Form popularity	Fillable & printable
2020	4.6 Satisfied (42 Votes)
2008	4.3 Satisfied (38 Votes)

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