|
In our continuing effort to better
serve our patients and their doctors Providence Place now offers our
Application for Admission
in an easy to download format. Simply click and
print.
The first page of the application is entitled Personal Information.
This page is for the family to complete as it enables Providence
Place to ascertain patient contact information and payment sources
that assist with the cost of health care services.
Bring all subsequent forms to your Primary Care Physician. The State
of Minnesota requires a Doctor’s Order to accompany any
admissions to a skilled nursing facility.
Be sure to include a current copy of the following;
-
Physician signed and dated History
and Physical
-
Physician signed and dated
Medication List
-
Physician signed and dated Advanced
Directives
-
Physician Order Form signed and
dated.
-
Physician signed and dated Standing
House Orders
-
Will the primary care physician
follow patient care after admission?
To assist you with the application
process we are available to answer your health care questions.
Please call Providence Place:
Admission: 612-968-1361
or
Fax Completed Forms to: 612-724-9884
BACK TO TOP |
