This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form DHCS5048?
A: Form DHCS5048 is the NTP Patient Death Report used in California.
Q: What is the purpose of Form DHCS5048?
A: The purpose of Form DHCS5048 is to report patient deaths in NTP (Narcotic Treatment Program) facilities in California.
Q: Who is required to fill out Form DHCS5048?
A: NTP facilities in California are required to fill out Form DHCS5048 in case of patient deaths.
Q: What information needs to be provided on Form DHCS5048?
A: Form DHCS5048 requires information such as the patient's name, date of birth, date of death, cause of death, and details of the NTP facility.
Form Details:
Download a fillable version of Form DHCS5048 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.