Loading
Get Repatriation Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Repatriation Form online
Filling out the Repatriation Form online is an essential task to ensure the smooth transition of patients back to your hospital. This guide provides comprehensive and supportive instructions to help you navigate the form efficiently.
Follow the steps to complete the form accurately.
- Press the ‘Get Form’ button to obtain the Repatriation Form and open it in the designated editor.
- Enter the patient’s details in the appropriate fields. Include the patient's name, date of birth (DOB), and sex. Fill in the address and postcode, ensuring accuracy to avoid delays.
- Provide the patient’s NHS number. This is crucial for identification and should be entered correctly.
- Specify the hospital the patient is being repatriated from and the ward they are currently on. Include the ward contact number for direct communication.
- In the referring details section, ensure your consultant has accepted the patient for repatriation. Fill in your contact number or bleep, and the name of the referring consultant or doctor.
- Include the accepting consultant’s contact number or bleep and specify the date and time when the patient was referred.
- Provide the current diagnosis, treatment plan, and medication list of the patient to assist in their continued care.
- Note any special requirements or important information related to the patient's care that may be necessary for their transition.
- Indicate the infectious status of the patient and specify whether they require a follow-up appointment at your hospital.
- Finally, fill in the referral contact name and number to facilitate communication during the repatriation process.
- Once all fields are complete and correct, save your changes to the Repatriation Form. You can then download, print, or share the form as needed.
Complete the Repatriation Form online today to ensure efficient patient care.
The U.S. Repatriation Program was established in 1935 under Section 1113 of the Social Security Act to provide temporary assistance to private U.S. citizens and their dependents identified by the Department of State (DOS) as having returned from a foreign country to the United States because of destitution, illness, ...
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.