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Transfer / Blue Form

Purpose:  To provide for more effective communication and collaboration between hospitals and assisted living facilities (ALF)/skilled nursing facilities (SNF). 

Please:

  • Print the Transfer Form on BLUE paper

       Download form for manual completion

       Download form for electronic completion

  • Send with any resident for an emergency room (ER) visit
     
  • Form can also be used for a clinic visit

 

 

 

 

Date Last Updated: 07/10/2019 3:33 pm