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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 01-212
for the current year.
DSHS Form 01-212 Altsa Nurse Delegation Referral and Communication Case / Resource Manager's Request - Washington
What Is DSHS Form 01-212?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 01-212?
A: DSHS Form 01-212 is a Nurse Delegation Referral and Communication Case/Resource Manager's Request form used in Washington.
Q: What is the purpose of DSHS Form 01-212?
A: The purpose of DSHS Form 01-212 is to request nurse delegation services and communicate with case/resource managers.
Q: Who uses DSHS Form 01-212?
A: DSHS Form 01-212 is used by nurses, case/resource managers, and healthcare providers in Washington.
Q: What is nurse delegation?
A: Nurse delegation is the process of assigning certain nursing tasks to trained and qualified individuals who are not licensed nurses.
Q: Why is nurse delegation needed?
A: Nurse delegation is needed to ensure that individuals who require nursing care receive appropriate assistance and support.
Q: What information is included in DSHS Form 01-212?
A: DSHS Form 01-212 includes information about the individual receiving care, the nursing tasks to be delegated, and the healthcare provider's contact details.
Q: How can DSHS Form 01-212 be submitted?
A: DSHS Form 01-212 can be submitted electronically or by mail to the appropriate DSHS office.
Form Details:
- Released on July 1, 2017;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 01-212 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
Download DSHS Form 01-212 Altsa Nurse Delegation Referral and Communication Case / Resource Manager's Request - Washington
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