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Instructions for Form F-01160 Acknowledgement of Receipt of Hysterectomy Information - Wisconsin
This document contains official instructions for Form F-01160 , Acknowledgement of Receipt of Hysterectomy Information - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-01160 is available for download through this link.
FAQ
Q: What is Form F-01160?A: Form F-01160 is an Acknowledgement of Receipt of Hysterectomy Information form.
Q: Who needs to fill out Form F-01160?A: Patients who are undergoing a hysterectomy in Wisconsin need to fill out Form F-01160.
Q: What is the purpose of Form F-01160?A: The purpose of Form F-01160 is to acknowledge that the patient has received information about the procedure and its risks.
Q: Is Form F-01160 specific to Wisconsin?A: Yes, Form F-01160 is specific to Wisconsin and is required for hysterectomies performed in the state.
Q: Do I need to keep a copy of Form F-01160?A: Yes, it is recommended to keep a copy of Form F-01160 for your records.
Q: What information does Form F-01160 require?A: Form F-01160 requires the patient's name, date of birth, date of the procedure, and signature.
Q: Can someone else fill out Form F-01160 on behalf of the patient?A: No, Form F-01160 must be filled out and signed by the patient.
Q: Are there any fees associated with filing Form F-01160?A: No, there are no fees associated with filing Form F-01160.
Q: What should I do with Form F-01160 after filling it out?A: After filling out Form F-01160, you should provide a copy to your healthcare provider and keep a copy for your records.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Also available in Spanish;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.
