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Get Custodian Records
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How to fill out the Custodian Records online
Filling out the Custodian Records form is an important process for certifying medical records. This guide provides clear instructions to assist users in accurately completing the form online, ensuring that all necessary information is included in a user-friendly manner.
Follow the steps to complete the Custodian Records form accurately.
- To begin, click the ‘Get Form’ button to access the Custodian Records form and open it in your preferred editor.
- Enter your name as the duly authorized custodian of the medical records in the designated space. Ensure accuracy to reflect your authority.
- Provide the name of the individual whose medical records you are certifying. This must be the person whose treatment records are attached.
- Indicate the date range of treatment by filling in the start and end dates. Use correct dates to avoid discrepancies.
- Input the name of the healthcare institution or office where the treatment was provided. Make sure this information is correct.
- List the personnel who prepared the records in the appropriate section, ensuring you specify the physicians or staff members involved.
- Write down the reasonable charges incurred for providing copies of these records. Be sure this reflects the actual costs.
- At the end of the form, sign your name as Custodian to certify that the information provided is true and correct.
- Finally, save any changes you have made, and download, print, or share the completed form as necessary.
Start filling out your Custodian Records form online today!
A custodian is an organization or entity defined in section 1(1)(f) of the HIA or designated in section 2 of the Health Information Regulation. Examples of custodians include physicians, chiropractors, nurses, Alberta Health Services and Alberta Health.
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