This document contains official instructions for Form F-01160 , Acknowledgement of Receipt of Hysterectomy Information - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-01160 is available for download through this link.
Q: What is Form F-01160?
A: Form F-01160 is an Acknowledgement of Receipt of Hysterectomy Information form.
Q: Who needs to fill out Form F-01160?
A: Patients who are undergoing a hysterectomy in Wisconsin need to fill out Form F-01160.
Q: What is the purpose of Form F-01160?
A: The purpose of Form F-01160 is to acknowledge that the patient has received information about the procedure and its risks.
Q: Is Form F-01160 specific to Wisconsin?
A: Yes, Form F-01160 is specific to Wisconsin and is required for hysterectomies performed in the state.
Q: Do I need to keep a copy of Form F-01160?
A: Yes, it is recommended to keep a copy of Form F-01160 for your records.
Q: What information does Form F-01160 require?
A: Form F-01160 requires the patient's name, date of birth, date of the procedure, and signature.
Q: Can someone else fill out Form F-01160 on behalf of the patient?
A: No, Form F-01160 must be filled out and signed by the patient.
Q: Are there any fees associated with filing Form F-01160?
A: No, there are no fees associated with filing Form F-01160.
Q: What should I do with Form F-01160 after filling it out?
A: After filling out Form F-01160, you should provide a copy to your healthcare provider and keep a copy for your records.
Instruction Details:
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.