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  • MEDICAL ASSESSMENT FOR RESIDENTIAL CARE FACILITIES FOR THE ELDERLY
    NOTE TO LICENSED MEDICAL PROFESSIONAL: The person patient named below is either a prospective resident or resident of a Residential Care Facility for the Elderly (RCFE) licensed by the Department of Social Services The licensee is required to provide primarily non-medical care and supervision to meet the needs of that person patient
  • Download the LIC 602 Form (Physician’s Report for RCFE Placement)
    That’s why we’ve created this helpful resource page to explain the LIC 602 Form, also known as the Physician’s Report, and how it fits into the process of moving into a licensed Residential Care Facility for the Elderly (RCFE) in California
  • Form LIC602 Download Fillable PDF or Fill Online . . . - TemplateRoller
    The latest version of the Form 602 LIC was issued by the California Department of Social Services (CDSS) on July 1, 2022 , with all previous editions obsolete A fillable version of the form is available for download below
  • CA LIC 602A 2011-2026 - Fill and Sign Printable Template Online
    Complete CA LIC 602A 2011-2026 online with US Legal Forms Easily fill out PDF blank, edit, and sign them Save or instantly send your ready documents
  • Physicians Report For Community Care Facilities (LIC 602)
    Physician's Report For Community This government document is issued by Department of Social Services for use in California The purpose of the LIC 602 form is to collect information about an individual seeking admission or continued care in a residential care facility
  • LIC 602A. PDF - RCFE Association
    PATIENT'S DIAGNOSIS (To be completed by the physician) NOTE TO PHYSICIAN: The person named above is either a resident or prospective resident of a residential care facility for the elderly licensed by the Department of Social Services
  • LIC602. pdF - Turning Point Community Programs
    It includes any person who is unable, or likely to be unable, to physically and mentally respond to a sensory signal approved by the State Fire Marshal, or to an oral instruction relating to fire danger, and persons who depend upon mechanical aids such as crutches, walkers, and wheelchairs
  • MEDICAL ASSESSMENT FOR RESIDENTIAL CARE FACILITIES FOR THE ELDERLY
    NOTE TO LICENSED MEDICAL PROFESSIONAL: The person patient named below is either a prospective resident or resident of a Residential Care Facility for the Elderly (RCFE) licensed by the Department of Social Services The licensee is required to provide primarily non-medical care and supervision to meet the needs of that person patient
  • PHYSICIAN’S REPORT FOR COMMUNITY CARE FACILITIES
    It includes any person who is unable, or likely to be unable, to physically and mentally respond to a sensory signal approved by the State Fire Marshal, or to an oral instruction relating to fire danger, and persons who depend upon mechanical aids such as crutches, walkers, and wheelchairs
  • Physicians Report for Residential Care Facilities for the Elderly (RCFE)
    RESIDENT PATIENT INFORMATION (To be completed by the resident resident's responsible person) 1 NAME 2 BIRTH DATE 3 AGE III AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION hereby authorize release of medical information in this report to the facility named above SIGNATURE OF RESIDENT AND OR RESIDENT'S LEGAL REPRESENTATIVE ADDRESS 3 DATE





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