Get Wa Hca 13-794 2018-2026

The WA HCA 13-794 form is a prescription form essential for documenting medical necessities for equipment or supplies. This guide provides clear instructions on how to effectively fill out the form online to ensure that all required information is accurately submitted.

Follow the steps to successfully complete the WA HCA 13-794 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling out Section I, which includes the patient’s name, date of birth, and diagnosis. Be sure to provide accurate information as this is critical for processing.
3. Next, indicate the length of need for the prescribed supplies. You can specify if it is less than 6 months or greater than 6 months, and if applicable, number of months should also be included.
4. Move to Section II. Here, you will list the items being prescribed, the quantity required, and the frequency of use for these supplies.
5. In Section III, enter the physician’s printed name, address, telephone number, fax number, city, state, and zip code. Make sure to include the physician's National Provider Identifier (NPI).
6. The physician must certify the accuracy of the information in Sections I and II by signing and including their credentials. Ensure this is completed to validate the prescription.
7. Finally, save your changes, and choose to download, print, or share the completed form as needed.

Complete your WA HCA 13-794 form online to ensure prompt processing of your medical necessities.