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Asked by cmuniz11081

Section 1:

(A) Patient record element/excerpt:

(B) Page #:

(C) Title of form:

(D) Related HIT role/responsibility:

Date of Birth

1

Inpatient Face Sheet

Release of Information ROI – verify data consistency

Section 2:

(A) Patient record element/excerpt:

(B) Page #:

(C) Title of form:

(D) Related regulatory agency:

Section 3:

(A) Patient record element/excerpt:

(B) Page #:

(C) Title of form:

(D) Related policy/standard:

Section 4:

(A) Patient record element/excerpt:

(B) Page #:

(C) Title of form:

(D) Example of index, database, or registry that data could be used for

Section 5:

(A) Patient record element/excerpt:

(B) Page #:

(C) Title of form:

(D) Who collected/recorded the information? (name and title)

Section 6:

Criteria/Design Element:

Present in form (Yes/No):

Explanation:

SCIENCE
HEALTH SCIENCE
NURSING
HITT 1301–46Z1

 
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