Get 1 Borang Perakuan Rawatan / Treatment Declaration Form Nama ...

Filling out the 1 Borang Perakuan Rawatan / Treatment Declaration Form online is an essential step for individuals seeking necessary treatment assistance. This guide will provide you with clear and concise instructions to navigate the form with ease.

Follow the steps to complete your treatment declaration form online.

1. Click the ‘Get Form’ button to access the form and open it in the designated editor.
2. Enter the patient's full name in the section labeled 'Nama Penuh Pesakit'. Make sure to check for any spelling errors.
3. Provide the patient's identification number in the 'No Kad Pengenalan' field. Ensure the number is accurate for proper identification.
4. In the 'Jenis Penyakit' section, specify the patient's diagnosis clearly.
5. Detail the patient's prognosis in the corresponding field, and be sure to circle the appropriate prognosis option: Good, Average, Fair, Guarded, Moderate, or Poor.
6. Fill out the 'Latar Belakang & Keadaan Pesakit' section, providing relevant background and current condition details.
7. Indicate the current treatment being received in the 'Rawatan Terkini' field.
8. Specify the frequency of treatments or follow-ups by ticking the appropriate option (weekly or monthly) and entering the respective numbers.
9. In the 'Jenis Bantuan yang diperlukan' section, select and list the type of assistance required, such as medication, equipment, or financial aid.
10. Provide any additional comments in the 'Lain-Lain Komen' section if needed.
11. Obtain confirmation from the attending specialist or medical officer by filling in their full name, official stamp, signature, and date in the designated areas.
12. Once all fields are completed, review the form for any errors. Users can then save changes, download, print, or share the completed form as necessary.

Complete your documents online today to ensure timely assistance with your treatment needs.