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Form CSO-1364B Statement From Medical Director / Designee of Inpatient Psychiatric Acute Care Hospital - Arizona
What Is Form CSO-1364B?
This is a legal form that was released by the Arizona Health Care Cost Containment System - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form CSO-1364B?
A: Form CSO-1364B is a statement from the Medical Director or Designee of an Inpatient Psychiatric Acute Care Hospital in Arizona.
Q: Who needs to fill out Form CSO-1364B?
A: The Medical Director or Designee of an Inpatient Psychiatric Acute Care Hospital in Arizona needs to fill out Form CSO-1364B.
Q: What is the purpose of Form CSO-1364B?
A: The purpose of Form CSO-1364B is to provide a statement from the Medical Director or Designee of the hospital regarding compliance with rules and regulations.
Q: Is Form CSO-1364B specific to Arizona?
A: Yes, Form CSO-1364B is specific to Arizona and is used for inpatient psychiatric acute care hospitals in the state.
Q: What information is required on Form CSO-1364B?
A: Form CSO-1364B requires information such as the name and address of the hospital, the name and contact information of the Medical Director or Designee, and a statement regarding compliance with rules and regulations.
Q: Are there any fees associated with Form CSO-1364B?
A: There may be fees associated with submitting Form CSO-1364B. It is recommended to contact the Arizona Department of Health Services or the hospital for more information.
Form Details:
- Released on September 1, 2022;
- The latest edition provided by the Arizona Health Care Cost Containment System;
- 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 CSO-1364B by clicking the link below or browse more documents and templates provided by the Arizona Health Care Cost Containment System.
