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[DOC File]COMPETENCY CHECKLIST (SAMPLE)
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I understand the Emergency Code procedures for the hospital and my role in patient safety. I agree with this competency assessment. I will contact my supervisor, manager or director if I require additional training in the future. Employee Signature: Date: Rev. 8/31/09 CHA_EmergencyCodes_Competency
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[DOCX File]Prohibited Items, Items That Often Require Pre-Purchase ...
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Prohibited Items, Items That Often Require Pre-Purchase Approval, and Fiscal Law Issues. Prohibited Items. Cash advances-Money orders, travelers’ checks, and gift certificates are also considered to be cash advances and will not be purchased by Cardholders, even to obtain items from merchants who do not accept the GPC.
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[DOCX File]Family Care Program - Enrollment
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Under Wis. Stat. § 49.45(4), your personally identifiable information is kept confidential and is only used for the direct administration of the Family Care program. ... If you are physically unable to sign, you may direct an adult to sign the form in front of two witnesses. The person who signs on your behalf should indicate that he or she is ...
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[DOC File]Exhibit 5-3: Acceptable Forms of Verification
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Child care expenses (including verification that a family member who has been relieved of child care is working, attending school, or looking for employment). Written verification from person who provides care indicating amount of payment, hours of care, names of children, frequency of payment, and whether or not care is necessary to employment ...
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[DOCX File]Microsoft Word - Advance Directive for Mental Health ...
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The usual symptoms of my identified mental disorder may include: _____ _____ _____ I direct my health care providers to follow my choices as set forth below: Medications for treatment of my mental illness: If I become unable to make informed choices for treatment of my mental illness, my wishes regarding medications are as follows:
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[DOC File]ADVANCE HEALTH CARE DIRECTIVE - Alaska
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In order for your advance directive to be valid, you must sign the form and it must be witnessed by one of two alternative methods described in the form (Sections 13, 14, and 15). ... I direct that my health care providers and others involved in my care provide, withhold, or withdraw treatment in accordance with the choice I have marked below ...
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[DOC File]Sample Letter Employers Can Give to Employees
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Title: Sample Letter Employers Can Give to Employees Author: 499420 Last modified by: 255287 Created Date: 4/27/2005 2:23:00 PM Company: Social Security Administration
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[DOCX File]JUSTIFICATION AND APPROVAL
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State whether the action will be awarded as a new contract or by modification to an existing contract (identify contract number) and identify the type contract planned (e.g., firm-fixed-price, cost-plus-incentive-fee, etc.).
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[DOC File]SUPERVISOR/EMPLOYEE COMMUNICATION LOG
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Title: SUPERVISOR/EMPLOYEE COMMUNICATION LOG Author: CCSD Last modified by: CCSD Created Date: 4/15/2008 10:53:00 PM Company: CCSD Other titles: SUPERVISOR/EMPLOYEE COMMUNICATION LOG
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CREDIT CARD AUTHORIZATION FORM
Authorization for Credit Card Use. PRINT AND COMPLETE THIS AUTHORIZATION AND RETURN. All information will remain confidential Name on Card: _____ Billing Address: _____
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