The following is a list of the required documentation, which is necessary in order for the St. Margaret’s Admissions Committee to make an accurate clinical determination. Please submit the follow records with your completed application.
- Admissions Agreement click here for form
- Admissions Application click here
- Current History and Physical Exam click here for Pre-Admission Physical Exam Form
- Physician Certification of Need click here for form
- Transcripts of most recent hospitalizations or physician visits
- Nurse’s notes and Progress notes for last 30 days (if applicable)
- Physical/Occupational/Speech Therapy notes for last 30 days (if applicable)
- Hospital Discharge Summary (if applicable)
- Current Medication List
- Current Treatment orders including vent settings, IV rates, etc.
- Pertinent lab/radiology/diagnostic results
- Current diet orders
- Immunization record and proof of negative PPD test in last six (6) weeks
- Current plan of care for all disciplines
Providing this information at the time of application will assist the St. Margaret’s team in expediting a clinical determination.
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