This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form HCA13-752?
A: Form HCA13-752 is a Pediatric Palliative Care (PPC) Referral and 5-day Notification form for the state of Washington.
Q: What is Pediatric Palliative Care (PPC)?
A: Pediatric Palliative Care (PPC) is specialized medical care for children with serious illness that focuses on providing relief from symptoms, pain, and stress.
Q: What is the purpose of Form HCA13-752?
A: The purpose of Form HCA13-752 is to refer a child to a Pediatric Palliative Care (PPC) program and provide a 5-day notification to the healthcare system.
Q: Who should fill out Form HCA13-752?
A: Form HCA13-752 should be filled out by a healthcare provider or a healthcare facility that is referring a child to a Pediatric Palliative Care (PPC) program.
Q: What information is required on Form HCA13-752?
A: Form HCA13-752 requires information such as the child's demographic information, medical history, current condition, and the reason for the referral to the PPC program.
Form Details:
Download a printable version of Form HCA13-752 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.