Healthcare Documents

This form is used to request an accounting of disclosures of your Protected Health Information (PHI) made by Walmart and Sam's Club Pharmacies, Vision Centers, Opticals or Care Clinics. It provides a detailed list of disclosures made by these entities in the six years prior to your request. The form should be submitted separately for each location where you seek an accounting of disclosures.

This file provides comprehensive information about the Clicks Pharmacist Assistant Program, including the employer's commitment, investment, and opportunities for health professionals. It covers Clicks' market recognition, socio-economic contributions, and strategies for growth.

The Asthma Control Test™ (ACT) is a tool for people aged 12 years and older. It helps assess asthma control over the past 4 weeks with a simple scoring method. Share your results with your doctor to discuss your asthma management.

This file outlines the details and required consent for undergoing Ultherapy treatment using the Ulthera System. It explains the procedure, potential risks, and expected outcomes. Patients are required to sign this form to acknowledge understanding and consent.

The Washington State Department of Social and Health Services PPE Order Request Form is for individual providers to request personal protective equipment. Complete this form as a first step in acquiring necessary PPE. The form includes client information, COVID status details, and PPE requirements.

This document provides updates on the availability and ordering processes for Influenza and COVID-19 vaccines in the Peel Region, along with detailed information for health professionals.

This file provides information regarding STI screening tests, including the incubation period, window period, and detailed timetable for various STIs. It helps users understand the timing for symptoms and when to take the tests. Contact details for appointment scheduling with the University Health Center are included.

This file provides detailed instructions on how to log into MyChart and enter your COVID-19 home antigen test result. It includes steps to share your COVID-19 data, report your test results, and complete the necessary questionnaires. Follow these instructions to ensure your test result is properly recorded.

This form is required by the California Department of Social Services for admission to residential care facilities. It gathers applicant information including health, physical and mental condition, social factors, and needed services. The form helps determine the applicant's suitability for admission.

This file is the Asthma Medication Administration Form for the school year 2023-2024. It includes sections for health care practitioners and parents/guardians to provide necessary information about the student's asthma management. Instructions for medication administration and consent are also included.

This document is a comprehensive form that health care providers in Ontario must complete for each specimen submitted for testing. It details the patient information, submission details, and the specific tests requested. Proper completion ensures timely and accurate processing of laboratory tests.

This article published in Nitte University Journal of Health Science compares the efficacy of Contractubex® ointment and intralesional corticosteroid injections for treating hypertrophic scars in the maxillofacial region.