Request for acute hospital admission (psychiatric services)

Shape
 
Published: 24 Nov 2020
 
File type: PDF
 
File size: 63.29 kB
 
Length: 2 pages
 
Reading level: Medium

What it contains

Use this form to request psychiatric hospital admission for the injured worker you are providing care to. This form is to completed by the care provider to request psychiatric hospital admission for an injured worker.

Once completed send the form directly to the agent.