Patients use various forms to make decisions about their medical care, such as consent forms, advance directives, medical records, release of information forms, power of attorney, and living wills.
This document template allows a Maryland resident to appoint a health care agent and provide instructions for end-of-life care.
This document template provides a Virginia resident with the ability to appoint an agent to make health care decisions, receive protected health information, and provide instructions for a terminal illness, as well as direct an anatomical gift.
This document template provides an advance directive for health care for a competent adult residing in Alabama, including instructions regarding particular health care treatments and notes and drafting tips.
This online document is a Georgia-specific advance directive that allows an individual to appoint an agent to make health care decisions on their behalf and provide instructions for particular treatments, including life-sustaining treatments, organ donation, and disposition of remains.
This document template allows a New Jersey resident to appoint a health care representative to make health care decisions, including instructions for life-sustaining treatments and end-of-life care.
This document template allows a Tennessee resident to appoint someone to make health care decisions, including instructions for life-sustaining treatments or end-of-life care.
This document template allows a New Jersey resident to provide instructions to a health care provider regarding mental health medications, treatments, and admission into a mental health facility, and appoint a third party to make decisions if necessary, with integrated notes and drafting tips.
This document template allows a California resident to appoint an agent to make health care decisions and receive health care information, with the option to include instructions for particular treatments, including life-sustaining and end-of-life care.
This document allows an individual in New Hampshire to appoint an agent to make health care decisions and provide instructions regarding health care treatments, including the withholding or withdrawing of life-sustaining treatments.
An advance health care directive in Utah allows a declarant to express preferences for health care treatments and to appoint an agent to make decisions if the declarant is unable to do so, including directives for withholding or withdrawing life-sustaining treatments.
This document template allows an adult to authorize an agent to make health-care decisions and receive health information on their behalf, as well as provide written instructions for withholding or withdrawing life-sustaining treatments.
This document template allows individuals in Hawaii to provide written instructions and authorize an agent to make health-care decisions on their behalf, including directives for life-sustaining treatments or end-of-life care.
This document template allows a Mississippi resident to appoint an agent to make health-care decisions and receive health information on their behalf.
This template provides a certificate of group health plan coverage based on a template published by the Department of Labor, with integrated notes for important explanations and drafting tips.
This template form provides employers with five or more employees a California-compliant medical certification for pregnancy disability leave (PDL), transfer, and/or reasonable accommodation in accordance with California law.
This is a template form for a California-compliant medical certification under the CFRA for a health care provider to certify an employee's serious health condition, updated to comply with the California Civil Rights Department as of July 1, 2022.
This online document provides a template for a code of conduct for a hospital or other health care provider to use as part of its compliance program, based on federal law and with integrated notes.
This template provides instructions and preferences for mental health treatment, including medications, treatments, and admission to a health care facility, to an attorney-in-fact and health care provider.
This document template provides instructions to a health care provider regarding psychoactive medications, convulsive treatment, and emergency mental health treatment, with integrated notes and drafting tips.
This document template allows individuals in Kansas to provide instructions regarding end-of-life care and life-sustaining treatments, commonly referred to as a living will.
This document template allows individuals to provide instructions for medical treatment in the event of a terminal or irreversible condition, as well as express religious or moral considerations.
This online document provides a template for emergency medical care policy for hospitals and facilities without dedicated emergency departments, based on federal law and including ACA requirements.
This document template provides an easy way for employers to inform their employees about health insurance availability.
This template provides a form for the executive committee of a non-profit hospital or health care organization's board of directors to create a charter.
This document provides an outline template form for requesting certification of a serious injury or illness of a current military servicemember when an employee requests military caregiver leave under the Family and Medical Leave Act (FMLA).
This online document provides an outline template form for requesting certification of a family member's serious health condition under the Family and Medical Leave Act (FMLA) for employees requesting FMLA leave.
This template provides private employers with at least 50 employees a form to notify California employees of their eligibility for leave and their rights and responsibilities under the FMLA and CFRA, with integrated notes for important explanations and drafting tips.
This template provides a general job description for a Medical Director that can be tailored to the needs of hospitals, ASCs, and other health care facilities.
This template provides federal employers with a form to use when granting an exception to the COVID-19 vaccination requirement for employees with disabilities, based on federal law and a template drafted by the Safer Federal Workforce Task Force.
This authorization form allows an individual to provide permission to a covered entity under HIPAA to use or disclose their protected health information (PHI) for specific purposes, in accordance with HIPAA requirements but not necessarily state law.
This document template allows research subjects to authorize an organization conducting a clinical trial regulated by the FDA to use and disclose PHI under HIPAA regulations.
This paragraph describes a template contract for the disclosure of a limited data set between a HIPAA covered entity and recipient, as allowed by the HIPAA Privacy Rule.
This template policy outlines an entity's HIPAA compliance obligations when electing hybrid status under HIPAA.
This template provides a collaborative practice contract between a physician and a nurse practitioner, and can also be used for other types of non-physician practitioners (NPPs).
This policy template provides a comprehensive guide for health care organizations to legally review and prepare contracts, request contracts, and obtain internal approval.
This document template allows a Minnesota resident to appoint a health care agent to make health care decisions and provide personal instructions regarding health care treatments, including life-sustaining treatments or end-of-life care.
This document template creates an advance health care directive in Washington, allowing a declarer to provide instructions for the withholding, withdrawing, or continued administration of life-sustaining treatment in the event of a terminal or irreversible condition.
This policy provides a template for health care entities to screen individuals and entities against exclusion lists to avoid penalties and sanctions.
This document template allows a South Carolina resident to appoint a health care agent to make health care decisions and receive health care information on their behalf, including instructions regarding particular health care treatments and directives regarding life-sustaining treatments or end-of-life care.
This contract provides professional medical services to a hospital or other facility, with terms that favor the facility party, and includes provisions to satisfy federal health care program requirements.
This document template allows Massachusetts residents to appoint a health care proxy to make health care decisions, including personal instructions for treatments and end-of-life care.
This document template provides a New York resident with the ability to appoint a health care agent to make health care decisions and includes instructions for particular treatments, including life-sustaining and end-of-life care, as well as links to a Practice Note for counsel.
This template provides a Disclosure Statement for health care organizations to use to screen and vet vendors of medical products and supplies for conflicts of interest, based on federal law and requirements applicable to federal health care program participants.
This online document is a template policy for emergency medical care that meets the requirements of the Emergency Medical Treatment and Labor Act (EMTALA) and the Affordable Care Act (ACA), with potential additional requirements based on state or local law.
This document provides a template for a Financial Assistance Policy containing the Internal Revenue Service (IRS) requirements for non-profit hospitals, with potential additional state or local law requirements to be integrated.
This template provides a plain language summary of financial assistance and charity care programs for non-profit hospitals, based on federal requirements and potentially supplemented by state or local law.
This online document is an informed consent template for a patient to access an investigational drug, meeting FDA requirements and industry standards.
This document template enables individuals to make end-of-life decisions in the event of a terminal illness.
This online document is a medical power of attorney template which allows an individual to appoint an agent to make health care decisions in the event of incapacitation, with the option to provide instructions or limit the agent's decision making authority.
This template provides an individual with a combined medical power of attorney and living will, with integrated notes and drafting tips.
This online document is a Medical Record Documentation Policy template based on federal law, which can be adapted to meet additional state laws and regulations.
This online document is an annual conflict of interest disclosure statement for physician members of a hospital medical staff, which requests information about potential conflicts of interest and requires an attestation of truthfulness.
This document provides a template for MAOs and PDPs to follow when delegating responsibility to FDRs to ensure Medicare compliance.
This document template allows a Michigan resident to designate a patient advocate to make health care decisions and receive protected health care information, with the option to include personal instructions regarding specific health care treatments.
This online document is a template for a contract setting out the terms and conditions for full-time employment of a physician, taking into account the Stark Law and Anti-Kickback Statute (AKS) regulations, including the 2020 revisions.
This policy template provides a comprehensive approach for health care organizations to develop, document, approve, implement, update, retain, and evaluate policies that are compliant with legal, compliance, and licensure requirements, and reflect the organization's mission and standards.
This policy provides guidance to institutional health care providers on managing legal risks associated with physician-owned distributors (PODs) or other vendor entities financially connected to physicians.
This document template allows a Wisconsin resident to appoint an agent to make health care decisions, including personal instructions regarding treatments and end-of-life care.
This document template allows a Nebraska resident to appoint a health care agent to make health care decisions and receive health care information on their behalf, with the option to include instructions regarding specific health care treatments.
This document template allows a Washington resident to grant an agent the authority to make health care decisions on their behalf, with the option to provide instructions or limit the agent's decision-making power.
This Standard Clause provides an outline template for healthcare companies to ensure compliance with data privacy and security laws when included in underwriting contracts in a registered securities offering, with integrated notes and drafting tips.
This paragraph outlines the procedures for a group health plan to determine if a medical child support order is qualified (QMCSO).
This document allows a North Carolina resident to appoint a health care agent to make health care decisions, including personal instructions for treatments.
This SAR provides a simplified financial statement of the plan and informs participants of their rights to receive additional plan information, in accordance with ERISA.
This template provides health care providers and facilities with a disclosure notice to provide to patients as required under the No Surprises Act, based on federal requirements and potentially additional state law requirements.