Tampa general hospital staff
[PDF File]Chronic Care Management Services
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Chronic care management services, at least 20 minutes of clinical staff time directed by a physician . or other qualified health care professional, per calendar month, with the following required elements: Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death ... General supervision means when the ...
[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,
[PDF File]2014 Code of Ethics
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• 3 • ACA Code of Ethics Purpose The ACA Code of Ethics serves six main purposes: 1. The Code sets forth the ethical obligations of ACA members and provides guidance intended to inform the ethical practice of professional counselors. 2. The Code identifies ethical considerations relevant to professional counselors and counselors-in-training. 3. The Code enables the association to clarify ...
[PDF File]NICHQ Vanderbilt Assessment Scale—TEACHER Informant
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Symptoms (continued) Never Occasionally Often Very Often 32. Feels worthless or inferior 0 1 2 3 33. Blames self for problems; feels guilty 0 1 2 3
[PDF File]Application For Supplemental Security Income (SSI)
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APPLICATION FOR SUPPLEMENTAL SECURITY INCOME (SSI) Form Approved OMB No. 0960-0229. Page 1. TEL Note: Social Security Administration staff or others who help people apply for SSI will fill out this form for you. I am/We are applying for Supplemental Security Income and any federally administered state supplementation under Title XVI of the Social
[PDF File]Application for Social Security Card
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Application for a Social Security Card. ... Certificate of Naturalization, employee identity card, certified copy of medical record (clinic, doctor or hospital), health insurance card, Medicaid card, or school identity card/record. For young children, we may accept medical ... GENERAL: Items on the form are self-explanatory or are discussed ...
[PDF File]COLUMBIA-SUICIDE SEVERITY RATING SCALE (C-SSRS)
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General non-specific thoughts of wanting to end one’s life/commit suicide (e.g., “I’ve thought about killing myself”) without thoughts of ways to kill oneself/associated methods, intent, or plan during the assessment period. Have you actually had any thoughts of killing yourself? If …
[PDF File]Information about Form 8850 and its separate instructions ...
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City or town, state, and ZIP code If, based on the individual’s age and home address, he or she is a member of group 4 or 6 (as described under
[DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal
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Limited to full scope inpatient hospital and inpatient mental health services only, for inmates in county correctional facilities who receive those services off the grounds of the correctional facility. F4 Restricted No ACIP Title (XIX/Title XXI). ... Aid Codes Master Chart (aid codes) ...
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