21 hours ago Step 1: Patient Name and Full Address. For a patient advocate form, the first thing that needs to be done is the heading in the center alignment. Below the heading, you have to write your full name, address, and date of birth along the same alignment. Add your street address, area, and zip code along with the four-digit social security number. >> Go To The Portal
Patient Advocate Form Template If you are looking for an efficient form for your emergency purposes, then you should use an application form with a good framework and pre-loaded content. Download this Patient Advocate Form Template in PDF and get started with drafting the patient advocate form in no time.
Both the patient and the advocate will read the entire document and then sign at the end to confirm their acceptance of the agreement and make it official. You also need to include two witnesses of the entire process and make them sign the document with their full name as well! 1. Patient Advocate Form Template
To make someone trustworthy your ‘patient advocate’ you need a patient advocate form. Since it is an important document that affects your health, you need to make sure that this form is error-free and has been drafted accordingly.
Connect With Services Patient Advocate Foundation. A national 501 (c)(3) non-profit charity that provides direct services to patients with chronic, life threatening and debilitating diseases to help access care and treatment recommended by their doctor.
Patient Advocate Foundation (Foundation or PAF) is a national nonprofit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases. The Foundation assists patients throughout the United States and is supported primarily through grant contributions, cooperative agreements, and service agreements with nonprofit organizations.
During both 2020 and 2019, the Foundation paid consulting fees of $780,000 to National Patient Advocate Foundation (NPAF). NPAF and the Foundation have the same individual as their Chief Executive Officer. These fees are governed by an arm’s length contractual arrangement between the two separate organizations and are in accordance with Internal Revenue Service guidelines dealing with transactions between a section 501(c)(3) organization and a section 501(c)(4) policy making entity. At June 30, 2020 and 2019, there was $41,713 and $18,437, respectively, due from NPAF to the Foundation which is included on the statements of financial position. At June 30, 2020 and 2019, there was $52,641 and $10,290, respectively, due to NPAF from the Foundation which is included on the statements of financial position.
Financial instruments which potentially subject the Foundation to concentration of credit risk consist principally of cash with various banks and investment securities. The Foundation places its temporary cash investments with high credit quality financial institutions. Accounts at each financial institution are insured by the Federal Deposit Insurance Corporation (FDIC) up to $250,000 or the Securities Investor Protection Corporation (SIPC) up to $500,000. At times, The Foundation places deposits in financial institutions that may be in excess of insured amounts. At June 30, 2020 and 2019, deposits of approximately $210,000,000 and $270,000,000, respectively, was in excess of insured amount. The Foundation has not experienced any financial loss as a result of such deposits.
In 2019, PAF completed work on two grants from the Robert Wood Johnson Foundation (RWJF), including “ Skilled Communications Workshops, a Dissemination Grant for the Roadmap to Creating Consumer Clarity in Health Care Decision Making,” and “Raising Awareness of the Importance of and Facilitating Cost-of-Care Discussions in Health Care”. These are the second and third grants RWJF has awarded PAF.
PAF’s Health Equity platform continues to identify and interact with a myriad of grassroots and national partners through its Community Engagement and Outreach Initiative. The intentional focus on community allows PAF to better understand unique, local experiences and apply those learnings into responsive program design and outreach activities to meet those needs. Recent outreach and engagement efforts have focused on African American and Latina women with breast cancer in Chicago and Memphis, and persons with lung cancer residing in the Appalachian region. The community engagement model used by PAF continues to yield positive results. Engagement activities include convening community meetings/listening sessions; conducting focus groups and key interviews; and convening of grassroots organizations to better understand resource gaps and to facilitate opportunities for collaboration. Through partnerships with organizations such as National Black Nurses Association (NBNA), National Hispanic Nurses Association (NHNA), Coalition of 100 Black Women (Memphis Chapter) along with a host of grassroots organizations such as Sisters Working It Out, Sister’s Network (Memphis and Chicago), Caregivers Respite and others, PAF is able to engage with health care providers, patients and caregivers to bring awareness of local and national resources that assist the populations they serve. Through two national and seven local outreach events, PAF reached more than 2,540 patients, caregivers, lay health navigators and nurses during the 2020 fiscal year. In 2019, the outreach events reached more than 2,880 patients, caregivers, community health workers, lay health navigators and nurses through 3 national and 9 local events.
PAF extends the impact of one-to-one case management services through the development of patient education and empowerment tools that provide actionable advice and guidance to healthcare consumers. The goal is to improve the patient’s everyday experience with the healthcare system and to empower the patient’s healthcare engagement. Our educational portfolio covers a broad range of topics in a variety of formats to meet the needs and preferences of multiple audiences, including patients, caregivers, and healthcare professionals.
The Foundation promotes health equity by addressing social needs gaps and social determinants of health at the individual, community, and national level. Broad local and national events address populations with low socio-economic characteristics and focus on communities with high disease morbidity and premature mortality from the leading causes of death. Specific activities focus on tackling social/financial support needs and mitigating barriers that impact access to health services.