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PHYSICIAN CERTIFICATION / RECERTIFICATION OF TERMINAL ILLNESS INITIAL / 2ND 90-DAY PERIOD Patient Name: (Rev. 11/13) CERTIFICATION STATEMENT ID# First 90-Day Period from to RN Signature Form # HC8007-A.

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How to fill out the HC8007-A. Instoc online

Filling out the HC8007-A form is a crucial step in certifying terminal illness for patients. This guide provides a clear and supportive outline to help users understand each section of the form and how to complete it efficiently online.

Follow the steps to complete the HC8007-A. Instoc online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the patient’s name in the designated field. This ensures the document is correctly attributed to the individual receiving care.
  3. Fill in the ID number associated with the patient in the specified box. This identification is essential for accurate record-keeping.
  4. Indicate the first 90-day period by entering the start and end dates. This provides a clear timeframe for the initial certification of terminal illness.
  5. In the certification statement section, affirm the patient’s terminal illness status. Clearly state the prognosis and review key clinical information to support this determination.
  6. Compose a brief narrative statement summarizing the patient's clinical circumstances to justify the need for hospice services. This should reflect a thorough understanding of the patient's condition.
  7. Confirm the authorship of the narrative by completing the attestation fields with the Hospice Medical Director or designee’s printed name and signature, noting the date of completion.
  8. For the recertification section, fill in the second 90-day period dates and repeat the certification process, ensuring a review of the clinical record is documented.
  9. Again, provide a narrative justifying the continued hospice service and complete the attestation with the appropriate signatures and dates.
  10. Once all sections are completed, review the form for accuracy, and use the options to save changes, download, print, or share the completed document.

Complete the HC8007-A. Instoc form online today to ensure timely care for your patients.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232