Form LIC 627C. Consent For Emergency Medical Treatment - Adult And Elderly Residential Facilities
The LIC 627C Consent for Emergency Medical Treatment Form is a vital document required by Adult and Elderly Residential Facilities in certain situations. The purpose of this form is to obtain the consent of an individual or their authorized representative for emergency medical treatment if the need arises, and they are unable to provide informed consent at the time.
The form consists of several parts including the name of the resident, contact information, and details of the individual who will provide informed consent on their behalf. It also includes important fields such as the types of medical treatments that the individual agrees to, any restrictions, and the duration of the authorization. The parties involved include the resident or patient, their authorized representative, and the facility staff.
It is important to consider when filling out this form, that accurate and up-to-date information must be provided to ensure appropriate emergency medical treatment is received. The data required include personal information, medical history, allergies, and any medications currently taken. Additionally, documents such as advanced directives and power of attorney may need to be attached, depending on the facility's policies.
An application example of this form can be seen in situations where elderly individuals reside in assisted living facilities that require special medical attention. This form allows them to receive immediate medical attention in case of an emergency. A strength of this form is that it ensures proper medical care is provided in emergency situations. A weakness could be that some residents or authorized representatives may not fully understand the terms on the form.
Alternative forms to this include the Advanced Health Care Directive and the Durable Power of Attorney for Health Care. The differences between these forms are that the Advanced Health Care Directive outlines specific medical instruction while the Durable Power of Attorney for Health Care delegates decision-making authority to a chosen representative.
Upon submission, this form is stored in the facility's records and is accessible to authorized staff members only. The form affects the future of participants by ensuring proper emergency medical treatment is provided promptly.
In conclusion, the LIC 627C Consent for Emergency Medical Treatment Form is a critical document that ensures prompt and appropriate medical care for elderly residents in assisted living facilities. It is important to ensure accurate information is provided, and necessary documents are attached to the form to avoid any delays in emergency medical treatment.