Washington Uniform Healthcare Act Form

State:
Multi-State
Control #:
US-01613
Format:
Word; 
Rich Text
Instant download

Description

This form is a model example of an Advance Health Care Directive. It may not comply with the law of your state on health care directives, medical power of attorney and/or living wills - and must be adapted to the law of your state.

The Washington Uniform Healthcare Act Form is an essential document that provides individuals with a legal framework to make decisions regarding their healthcare, especially in critical situations where they may not be able to express their wishes. This act ensures that individuals' healthcare choices are respected and followed, regardless of their ability to communicate. Key features of the Washington Uniform Healthcare Act Form include the designation of a healthcare agent, who is authorized to make healthcare decisions on behalf of the individual; the declaration of specific healthcare preferences, such as preferred treatments, providers, or medical facilities; and the designation of organ donation choices. This form empowers individuals to have control over their healthcare, even if they are unable to speak or make decisions themselves. There are two main types of Washington Uniform Healthcare Act Forms commonly used by individuals in the state of Washington: 1. Washington Uniform Healthcare Act Form for Adults: This form allows adult individuals (18 years old and above) to designate a trusted person as their healthcare agent and express their healthcare preferences. It enables them to make decisions regarding their medical treatments, end-of-life care, and organ donation choices. 2. Washington Uniform Healthcare Act Form for Minors: This specific form is designed for parents or legal guardians of minor children (under the age of 18) to appoint a person as their child's healthcare agent. It ensures that a trusted individual can make healthcare decisions on behalf of the child, adhering to the child's best interests and the preferences expressed by the parent or guardian. By completing the Washington Uniform Healthcare Act Form, individuals can ensure that their healthcare preferences are heard and honored when they are unable to advocate for themselves. It serves as an invaluable tool for providing clear instructions to healthcare professionals, granting decision-making authority to trusted individuals, and ensuring peace of mind for both patients and their families.

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FAQ

(1) Information and records related to mental health services delivered to a person subject to chapter 9.94A or 9.95 RCW must be released, upon request, by a mental health service agency to department of corrections personnel for whom the information is necessary to carry out the responsibilities of their office.

How do I request a copy of a public document? Please Submit a request through the new Public Records Request Portal. It will prompt you to create an account after selecting, Submit a Records Request. The request must be for a specific identifiable record or series of records.

Contact our public records officer by email at PRD@doh.wa.gov or phone at 360-236-4220.

A patient may revoke in writing a disclosure authorization to a health care provider at any time unless disclosure is required to effectuate payments for health care that has been provided or other substantial action has been taken in reliance on the authorization.

If your medical record is not available online, you may request a copy in writing from your provider. The simplest way to do this is to call and ask how to request a copy of your records. You may also be able check their website online and see if they have a release of records form available for you to fill out.

How long does my doctor keep my medical record? Check with your provider regarding the length of record retention. Washington State Law requires hospitals to retain medical records which are related to the care and treatment of the patient for a period of not less than 10 years following the most recent discharge.

The Uniform Health Care Information Act adopted by the Washington State Legislature went into effect on July 28, 1991. The Act provides direction for health care providers, health care facilities, patients and other persons on access to medical records, and what can be charged for copies of records.

Your provider can charge a "reasonable fee" for your copies. You may have to pay up front. In 2022, a health care provider can charge up to $1.24 a page for the first thirty pages, 94 cents a page after that, and a $28 clerical fee. WAC 246-08-0400.

More info

Uniform Medical Plan (UMP) is a self-insured health plan offered through the Washington State Health Care Authority's (HCA) Public Employees Benefits Board ( ... Step 3: Find and complete forms. All services or items requiring prior authorization must be submitted on the General Information for Authorization (form 13-835) ...Please complete the top section of this form and have the Dean of a Washington accredited school of medicine or Chief Executive (Medical). Officer of a licensed ... Simply click on the appropriate form, fill out the form ... This form is only available to registered medical providers by logging into the OWCP Web Bill Portal. The primary source for confidentiality and the requirements for the release of medical/health records in Washington is found in the Uniform Health Care ... by CP Sabatino · 2010 · Cited by 333 — The Uniform Act provides an optional sample form with options to give instructions about one's care, appoint an agent, make an organ or tissue donation, and ... Most Maryland court forms and brochures are available in this index. Use the filters on the left to narrow your search by topic, court, and language. Applications and forms for health care professionals in the Aetna network and their patients can be found here. Browse through our extensive list of forms ... Uniform Medical Plan (UMP) is a health plan offered through the Washington ... Submit the form through Availity Essentials to avoid claims processing delays. After completing this form, sign and date the form at the end. You must have 2 other individuals sign as witnesses. Give a copy of the signed and completed form ...

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Washington Uniform Healthcare Act Form