Department of Community Health

State of Georgia

Official Website: https://dch.georgia.gov/

Forms & Documents

Browse all Department of Community Health government forms

41 - 60 of 64 forms

Form Title Topics
Laboratory Self-Report - Updated 7/13/17
Lab Personnel List - Updated 7/6/17
Letter of Determination - Ambulatory Surgical Center - Updated 06/28/24
Letter of Determination - Equipment – Updated 06/28/24
Letter of Determination - Miscellaneous - Updated 06/28/24
Medication Administration Training Curriculum for Proxy Caregivers
Multi-Ingredient Compound Drug Prior Authorization Request Form
NURSING HOME APPLICATION CHECKLIST
Nursing Homes Incident Report
OPIOID MME MAXIMUM PA FORM
PERSONAL CARE HOME APPLICATION CHECKLIST
Personal Care Homes - Physician's Medical Evaluation for Assisted Living
PHYSICIAN'S MEDICAL EVALUATION FOR ASSISTED LIVING
Provider Administered Drug Form
Provider Request for Extended Repayment Plan - Posted 12/4/18
Providers' Administered Drug List (PADL) Review Request Form
REQUIRED HOSPITAL SELF REPORTS TO THE DEPARTMENT
Signed Repayment Plan Policy - Updated 03/27/15
Swing Bed Application
Synagis Policy Statement RSV Season 2020-2021 - Posted 06/16/21

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