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22670 Haggerty Road, Suite 100, Farmington Hills, Michigan 48335

Phone: 248-465-7300  |  Fax: 248-465-7428 

At MPRO, we are committed to maintaining an environment of equal opportunity and affirmative action. If you need a reasonable accommodation to access the information provided on this website, please contact us at 248-465-7300 for further assistance.

Skilled Nursing Facility (SNF) to Emergency Department (ED) Hand Off

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SNF to ED Handoff Form

 

This form is for skilled nursing facilities to complete and provide to the emergency medical service (EMS) and receiving hospital before sending a resident to a hospital emergency department. Please download the form and use electronically or in paper form to transfer the information to the receiving hospital.

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SNF to ED Checklist

 

This checklist is for skilled nursing facilities to use as a guide. It lists all of the documents needed when sending a resident to a hospital emergency department. Please download the checklist and use electronically or in paper form to transfer the checklist and all documents listed to the receiving hospital.