- Physician Orders, for medication, treatment plan, and diet
- Physical Examination and Medical History
- Level One Screening for Mental Illness/Mental Retardation (LTC-14) and Mini Mental, if applicable
Note: These documents must be completed, signed by physician and the date of completion must be within (5) days prior to admission to Barfield Health Care.
- Chest X-Ray, we need the results only of the Chest X-Ray, not the actual X-Ray. The Chest X-Ray must be within (30) days prior to admission
A “packet” will be provided to you containing the necessary forms for the physician to complete for the admission to Barfield Health Care. If the resident is being admitted from the hospital, the hospital will provide us with the necessary medical paperwork.
We will need the following documents, if applicable, prior to approval for admission:
- Social Security Card
- Medicare Card
- Medicaid Card
- Insurance Cards
- Advance Directives
- Living Wills
- Power of Attorney, Guardianship or related documents
We must have paper work approved by agencies as applicable. Therefore, please do not bring resident to the facility until you have been requested to do so. Having an assigned time for admission makes the admission process better for the resident and the resident’s family.
Please print the Pre Admissions Form , complete it, and then mail or fax it to us.
You will need the Free Adobe Acrobat Reader to view the form.
Barfield Health Care, Inc.
22444 Highway 431
Guntersville, AL 35976