Microsoft Word - OT Vision Referral
... : • •• •• •• •• •• •• •• •• •• •• •• •• •• • Medical Diagnosis: ICD 10: Onset Date: OT Prescription for: (please select) OT Visual Skills Evaluation ...
business-associates.pdf
... Page 1 of 3 Issuing Department: Internal Audit, Compliance, and Enterprise Risk Management ... specific departments and responsibility lies therein for obtaining a BAA as necessary (e.g., Medical Center ...
NYU Langone Pediatric Surgery Associates | NYU Langone Health
The experts at NYU Langone Pediatric Surgery Associates specialize in minimally invasive and conventional surgical methods.
Radiation Therapy for Colorectal Cancer | NYU Langone Health
Doctors at NYU Langone’s Perlmutter Cancer Center use radiation therapy to treat people with colorectal cancer.
fgp-workers-comp-no-fault-insurance-registration-form.pdf
... /CARRIER CASE #_ CLAIM REPRESENTATIVE/ADJUSTOR NAME_ PHONE # EXT_ FAX # (OTHER MEDICAL) INSURANCE: ID ... PROCEDURE? WHAT PART OF THE BODY? WERE YOU GIVEN ANY MEDICATION? (YES/NO) IF YES, PLEASE LIST _ HAVE YOU ...
Mammography | NYU Langone Health
NYU Langone offers breast imaging services, such as screening and diagnostic mammograms, at multiple locations in the New York City area.
Adult Cardiac Surgery | NYU Langone Health
NYU Langone’s cardiac surgeons perform heart surgery, including heart valve procedures, for adults with heart-related conditions.
hie-fact-sheet-and-consent-albanian.pdf
... Langone health providers who may request access to your medical records for purposes of current treatment ... (“Care Everywhere Providers”) to obtain access to your medical records through a computer network ...
right-to-request-an-accounting-of-disclosures-of-phi.pdf
... Page 1 of 4 Issuing Department: Internal Audit, Compliance, and Enterprise Risk Management ... in the patient’s medical record or in the Accounting for Disclosures Database as required by the Accounting ...
Business Advisory Committee
... #:_________________________________________Insured Name:__________________________ Medical Diagnosis: ____________________________________ ICD code ...