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Lampiran 2 PERFORMANCE VERIFICATION FORM PVF: KPI Prepared by: CLINICAL PERFORMANCE SURVEILLANCE UNIT, MEDICAL DEVELOPMENT DIVISION, MOH TEL:038883 1180/ 1181/ 1200/ 1203/ 1208/ 1214; FAKS: 038883.

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How to fill out the Pvf Form online

The Performance Verification Form (PVF) is an essential document for certifying the accuracy of reported performance data in healthcare settings. This guide provides a clear, step-by-step approach to help users complete the form online, ensuring all necessary information is accurately captured.

Follow the steps to fill out the Pvf Form online:

  1. Press the ‘Get Form’ button to access the form and open it for editing.
  2. Begin by filling in the department or discipline and hospital details. Ensure to select the appropriate option that corresponds with your department.
  3. Indicate the type of indicator by marking the relevant checkbox for either 'Key Performance Indicator (KPI)' or 'Hospital Performance Indicator for Accountability (HPIA)'.
  4. Specify the reporting period by selecting the applicable timeframe (e.g., January – March) and completing the year and specific month fields.
  5. In the indicator section, enter both the numerator and denominator values, which represent the cases or patients relevant to the reported performance.
  6. Verify the performance data by ticking 'Yes' or 'No' in the data verification section. Ensure that the data source is clearly identified and specified in the provided boxes.
  7. If shortfalls in quality were observed, complete the notification and action boxes accordingly, stating the current status.
  8. In the declaration section, the officer in charge must provide their name, signature, designation, and affix the official chop, while also indicating the date of certification.
  9. Obtain the hospital director’s declaration, which includes their name, signature, designation, and date of agreement.
  10. Finally, ensure the form is saved, downloaded, printed, or shared as necessary for further processing.

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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