|
These are samples of the policies
in a compressed downloadable file.
Click to download:
|
|
Policy #
|
Policy Title
|
Document To Add
(Specific To Clinic)
|
|
0130
|
Participation Requirements |
Certification/Re-certification Application |
|
0211
|
Board of Directors Roster |
Area Provider Board Roster List |
|
0225
|
Area Board of Directors
|
Area Board of Directors Organizational Chart |
|
0230B
|
Site Admin. Council Roster |
Site Administrative Council Roster
|
|
0340
|
Site Operation |
Site Patient Flow Chart |
|
0400
|
Posting of Clinic License
|
Copy of Posted Clinic License |
|
0430
|
Fire Marshall Clearance |
Local Site Fire Marshall Clearance |
|
0710
|
Site Lease Agreement |
Site Letter of Control or Lease Agreement |
|
0731
|
Site Disaster Plans |
Site Disaster Plan |
|
0740
|
Site Fire Maps |
Site Fire Map |
|
0760
|
Site Earthquake Protocol |
Insert Phone Numbers on Page 2 |
|
1110
|
Site Medical Referral Roster |
Site Medical Referral Roster |
|
1210
|
Transfer Agreement |
Transfer Agreement Letters |
|
1410
|
Site Pharmacy Orders |
Formulary |
