Get G0260

The G0260 form, known as the AHB report, is essential for documenting rehabilitation application procedures. This guide will walk you through the necessary steps to complete the G0260 form online effectively.

Follow the steps to fill out the G0260 form accurately.

1. Click ‘Get Form’ button to access the G0260 form online in the editor.
2. Begin by entering the vehicle registration number and insurance number where indicated.
3. Provide the address of the AHB facility, if applicable, along with the hospital's address.
4. Fill in the contact person’s name, phone number, and fax number, and specify the type of procedure.
5. Indicate the proposed form of rehabilitation, selecting from options such as inpatient or outpatient care.
6. Enter the personal details of the patient, including their full name, birth date, and current address.
7. Document the admission date to the hospital and any relevant operations or acute events.
8. For the diagnosis, include the ICD-10-GM code and list the disease progression and complications.
9. Answer the medical history questions, specifying any relevant disabilities or treatment outcomes.
10. Provide details regarding the patient's mobility and assistance needs in the following fields.
11. Complete any additional remarks and ensure to check if the patient is capable of participating actively in rehabilitation.
12. Finally, gather all signatures required, including that of the physician, and ensure the document is fully legible before saving, downloading, or printing it.

Complete the G0260 form online now for efficient document management.