Form DHCS5048 Ntp Patient Death Report - California

Form DHCS5048 Ntp Patient Death Report - California

What Is Form DHCS5048?

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.

FAQ

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.

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Form Details:

  • Released on March 1, 2017;
  • The latest edition provided by the California Department of Health Care 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 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.

Download Form DHCS5048 Ntp Patient Death Report - California

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  • Form DHCS5048 Ntp Patient Death Report - California, Page 1
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