Instructions for Form F-01160H Acknowledgment of Receipt of Hysterectomy Information - Wisconsin (Hmong)

This document contains official instructions in Hmong for Form F-01160H , Acknowledgment of Receipt of Hysterectomy Information - a form released and collected by the Wisconsin Department of Health Services.

FAQ

Q: What is Form F-01160H?
A: Form F-01160H is the Acknowledgment of Receipt of Hysterectomy Information form specific to Wisconsin and translated into Hmong language.

Q: Who needs to fill out Form F-01160H?
A: The form needs to be filled out by patients who have received information about hysterectomy procedures in Wisconsin and prefer to acknowledge their receipt in Hmong.

Q: What is the purpose of Form F-01160H?
A: The purpose of this form is to acknowledge that the patient has received information about possible health effects and alternatives to hysterectomy, specifically in the Hmong language.

Q: Do I need to submit Form F-01160H to any specific agency?
A: Generally, you do not need to submit this form to any specific agency. It is mostly for your own records and to confirm receipt of the information.

Q: Is there an English version of this form available?
A: Yes, there is an English version of this form available, which is Form F-01160. However, Form F-01160H is specifically translated into Hmong for patients who prefer to receive information in that language.