CALIFORNIA DEPARTMENT OF SOCIAL SERVICES. PHYSICIAN#39;S REPORT FOR ... LIC 602A (8/11) (CONFIDENTIAL). PAGE 1 OF 6. 1. NAME. 2. BIRTH .

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How to fill out the 602 Form online

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.

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What is a Rcfe facility?

Residential Care Facilities for the Elderly (RCFE) and Adult Residential Care Facilities (ARF) are responsible for providing Assisted Living Waiver (ALW) services to participants, allowing them to maintain independence and continue to receive nursing level of care as needed.

Form 602 is an authorization form filed by each person who employs or contracts with a lobbying firm. This form serves as an attachment to Form 601, and is filed by the applicable lobbying firm. Form 602 also contains a schedule which describes by category the nature and interest of the client of the firm.

A Physician's Report Form 602 is a required document for every state licensed senior care facility in California. It is to be completed by a physician who will confirm a diagnosis, give TB clearance, and certify other healthcare needs and/or issues. It is not a comprehensive health history.

The results of a TB test are valid only for six months, while the results of a chest X-Ray are valid for one year.

What is Form 602? Form 602 is a specific type of physician's report that must be completed by all seniors living in elderly residential care facilities in California, regardless of whether they are residents of the state or moving in from another state.

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