Form F-01160 Acknowledgment of Receipt of Hysterectomy Information - Wisconsin

Form F-01160 Acknowledgment of Receipt of Hysterectomy Information - Wisconsin

What Is Form F-01160?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. Check the official instructions before completing and submitting the form.

FAQ

Q: What is Form F-01160?A: Form F-01160 is the Acknowledgment of Receipt of Hysterectomy Information form used in Wisconsin.

Q: What is the purpose of Form F-01160?A: The purpose of Form F-01160 is to document that a patient has received information about hysterectomy and its alternatives.

Q: Who needs to fill out Form F-01160?A: The form needs to be filled out by a patient who is going to undergo a hysterectomy procedure in Wisconsin.

Q: What information does Form F-01160 require?A: Form F-01160 requires the patient's name, date of birth, date of the physician's explanation of the procedure, and the patient's signature.

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Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Available in Hmong;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F-01160 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-01160 Acknowledgment of Receipt of Hysterectomy Information - Wisconsin

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