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DOH Form 651-034 Hemodialysis Authorized Representative Attestation Form - Washington
What Is DOH Form 651-034?
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 DOH Form 651-034?
A: DOH Form 651-034 is the Hemodialysis Authorized Representative Attestation Form in Washington.
Q: What is the purpose of DOH Form 651-034?
A: The purpose of DOH Form 651-034 is to authorize a representative to make decisions on behalf of a hemodialysis patient in Washington.
Q: Who is required to complete DOH Form 651-034?
A: The hemodialysis patient or their legal representative is required to complete DOH Form 651-034.
Q: Is DOH Form 651-034 specific to Washington?
A: Yes, DOH Form 651-034 is specific to Washington and is used to comply with state regulations.
Form Details:
- Released on February 1, 2018;
- The latest edition provided by the Washington State Department of Health;
- 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 DOH Form 651-034 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.
