DOH Form 665-011 Request for Physician Disciplinary Profile / Pmlexis Score Report - Washington

What Is DOH Form 665-011?

This is a legal form that was released by the Washington State Department of Health - 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 form 665-011?
A: Form 665-011 is the request form for a Physician Disciplinary Profile/PMLEXIS Score Report in Washington.

Q: What is a Physician Disciplinary Profile?
A: A Physician Disciplinary Profile is a report that provides information about a physician's disciplinary history.

Q: What is a PMLEXIS Score Report?
A: A PMLEXIS Score Report is a report that provides information about a physician's performance on the PMLEXIS exam.

Q: Who can request form 665-011?
A: Anyone can request form 665-011 to obtain a Physician Disciplinary Profile/PMLEXIS Score Report in Washington.

Q: How can I obtain form 665-011?
A: You can obtain form 665-011 by contacting the appropriate authority or agency in Washington.

Q: Why would someone request a Physician Disciplinary Profile/PMLEXIS Score Report?
A: Someone might request a Physician Disciplinary Profile/PMLEXIS Score Report to evaluate a physician's qualifications or to make an informed decision about their healthcare provider.

Q: Is there a fee for requesting form 665-011?
A: Yes, there may be a fee for requesting form 665-011. The specific fee amount can be obtained from the appropriate authority or agency in Washington.