Element A: Patient Information
1. Free and Charitable Clinics will gather patient demographic information and keep patient information in a medical record. Information may include but not be limited to:
• Date of birth
• Gender
• Race
• Home Address and/or Homelessness
• Ethnicity
• Preferred Language
• Telephone Numbers
• E-mail Addresses
• Dates of Clinical Visits
• Financial Information
• Eligibility Information
• Health Insurance Information
• Date of birth
• Gender
• Race
• Home Address and/or Homelessness
• Ethnicity
• Preferred Language
• Telephone Numbers
• E-mail Addresses
• Dates of Clinical Visits
• Financial Information
• Eligibility Information
• Health Insurance Information
| record_retention_policy__1_.docx |
| sample_eligibility_application.docx |
| records_retention_0.doc |