Get Adoform

Filling out the Adoform online can be a straightforward process if you follow the steps carefully. This guide provides a detailed walkthrough of each section to ensure that your objections are documented clearly and effectively.

Follow the steps to complete the Adoform accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name in the 'RN (name)' field. This identifies you as the individual completing the form.
3. Fill in the 'Date' field with the current date to establish when the form is completed.
4. Indicate the 'Facility/Clinic' where you work to provide context for your assignment.
5. In the 'Primary Care' section, specify the relevant primary care provider associated with the assignment.
6. Document your objections in the section labeled 'I have made my objections known to', mentioning the name of your Primary Care Manager (PCM).
7. Explain how the assignment has compromised your ability to provide quality patient care, referring to Time and Specialty Care factors as applicable.
8. In the 'DESCRIPTION OF SITUATION' field, check all applicable boxes to indicate why you are unable to complete daily tasks such as calls and messages.
9. Detail the effect on patient(s) and/or staff by completing the metrics indicated, such as counts of calls/messages not returned at the end of the shift.
10. Provide proposed solutions in the corresponding section, noting any individuals who should be included in the meeting to discuss these solutions.
11. Sign and date the form at the bottom to verify its accuracy and your agreement with the contents.
12. Review the completed form for errors or omissions before submission.
13. Give a copy of the completed form to your PCM/Manager and keep the original for your records.
14. Finally, fax a copy to (503) 657-7456 or mail it to OFNHP, 2045 SE Ankeny St, Portland OR, 97214.

Complete your Adoform online today to ensure your concerns are addressed promptly.