Release from Responsibility for Discharge Against Medical Advice (AMA) - DIGITAL
Electronically Delivered eForm* - Subscribe Today!
The advantages of Briggs Digital on Demand forms:
• | Updates included with annual subscription |
• | Form-fillable PDF documents at your fingertips |
• | Easy to complete on any device; or print when you need them |
• | No shipping charges or delivery delays |
• | Never on back order |
UPDATED 2024
Use this form to document that a resident is discharging him- or herself against the medical advice of the attending physician and that the resident has been informed of:
• | the risks and consequences of leaving the facility |
| • | the benefits of continued skilled or nursing facility care, |
| • | and alternatives if applicable. |
Captures date, time, all applicable signatures and documents the release of the attending physician, any other physician involved in care, the facility, and its agents or employees from all responsibility for any ill effects that may result from the decision to discharge against medical advice (AMA).
The form also documents if the resident refuses to sign the document.
Download a sample today!License Agreement
Send completed License Agreements toCustomerSupport@BriggsCorp.com
*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. This digital form is delivered as a form-fillable PDF and includes 1-year of updates. To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment) and provide the facility/agency address. After 1- year, your subscription will automatically renew.
All Briggs Digital on Demand products require a credit card payment (or pre-payment) to receive digital files electronically.
Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.
Delivery: Digital* form-fillable PDF
Digital/electronic merchandise & subscriptions: all digital and electronic products and subscriptions are non-refundable and non-returnable.
*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. This digital form is delivered as a form-fillable PDF and includes 1-year of updates. To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment) and provide the facility/agency address. After 1- year, your subscription will automatically renew.
All Briggs Digital on Demand products require a credit card payment (or pre-payment) to receive digital files electronically.
Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.