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Get Friends And Family Form - University Of Michigan Health System
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How to fill out the Friends And Family Form - University Of Michigan Health System online
The Friends And Family Form allows individuals to authorize family members and friends to be involved in discussions about their health care. This guide provides clear instructions to help you complete the form accurately and efficiently online.
Follow the steps to successfully fill out the Friends And Family Form.
- Press the ‘Get Form’ button to access the online version of the Friends And Family Form.
- Begin by entering your full name in the designated field. This ensures that the form is associated with your medical record accurately.
- Enter your registration number if applicable. This number is important for identifying your records within outpatient clinics.
- List the names and phone numbers of the family members or friends you wish to authorize for discussions about your health care. Ensure to include sufficient information for each person.
- Read the consent part of the form carefully. Check the boxes next to any applicable information that you wish to share, including details about communicable diseases, substance abuse services, or mental health services.
- Sign the form in the designated area to authenticate your request. Ensure that the signature matches the name printed above.
- In the relationship to patient section, indicate your relationship (self, legal representative, or guardian). If you are a guardian, ensure you have proof of your role ready.
- Finally, review all the information you have entered for accuracy. Once confirmed, you can save the changes, download a copy, print it out, or share it as needed.
Complete your Friends And Family Form online today to ensure your preferences for health care discussions are communicated.
Under the Michigan Public Health Code, medical records must be retained for a minimum period of seven years following the last date of service provided to a patient.
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