Form LIC627C Consent for Emergency Medical Treatment - Adult and Elderly Residential Facilities - California

Form LIC627C Consent for Emergency Medical Treatment - Adult and Elderly Residential Facilities - California

What Is Form LIC627C?

This is a legal form that was released by the California Department of Social 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 the LIC627C Consent for Emergency Medical Treatment form?
A: The LIC627C is a form used in California's adult and elderly residential facilities to obtain consent for emergency medical treatment.

Q: Who needs to sign the LIC627C form?
A: The resident or their legally authorized representative needs to sign the LIC627C form.

Q: Can the resident refuse to sign the LIC627C form?
A: Yes, the resident has the right to refuse or revoke their consent for emergency medical treatment by not signing the LIC627C form.

Q: Is the LIC627C form legally binding?
A: Yes, the signed LIC627C form establishes consent for emergency medical treatment and is legally binding.

Q: Can the facility provide emergency medical treatment without the LIC627C form?
A: In emergency situations where immediate medical treatment is necessary and the LIC627C form has not been signed, the facility can provide treatment to stabilize the resident.

Q: How long is the LIC627C form valid?
A: The LIC627C form is valid for one year from the date of signature, unless revoked or a different date is specified.

Q: Can the LIC627C form be modified or altered?
A: The LIC627C form cannot be modified or altered, and any changes must be made by completing a new form.

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Form Details:

  • Released on April 1, 2000;
  • The latest edition provided by the California Department of Social 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 LIC627C by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

Download Form LIC627C Consent for Emergency Medical Treatment - Adult and Elderly Residential Facilities - California

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  • Form LIC627C Consent for Emergency Medical Treatment - Adult and Elderly Residential Facilities - California, Page 1
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