Get 602 Form

The 602 Form is essential for documenting the health and medical status of residents in residential care facilities for the elderly. Completing this form accurately online ensures that facilities can provide appropriate care tailored to each individual's needs.

Follow the steps to complete the 602 Form effectively.

1. Click the ‘Get Form’ button to access the 602 Form and open it in your preferred editor.
2. In the Facility Information section, fill in the required details including the name, address, telephone number, licensee's name, and facility license number.
3. Complete the Resident/Patient Information section by providing the resident's name, birth date, and age.
4. In the Authorization for Release of Medical Information section, ensure that the resident or their legal representative signs and dates the authorization.
5. The physician should complete the Patient's Diagnosis section, including examination date, TB test information, blood pressure, primary diagnosis, and any secondary diagnoses or additional conditions.
6. Address any allergies or special health conditions by completing the relevant fields and indicating if the patient can manage their treatment independently.
7. Provide details regarding the physical and mental condition of the patient, documenting assistance devices or the need for supervision.
8. Complete the Ambulatory Status section, indicating the resident's ability to transfer independently and required support.
9. Review all sections to ensure completeness and accuracy, then prepare to submit.
10. Once completed, you can save changes, download, print, or share the completed form as needed.

Complete your documents online today for a smoother experience.