IWeb User Guide

402P Form (Louisiana)

This is a state-configurable option for the state of Louisiana, with two administrative property options (Administration > Settings > Properties > Registry Settings > Enable 402P Form Launch Button and Enable 402P Authorized Receiver Checkbox).

The 402P form must be completed for each non-covered requestor, such as parents, guardians, and third-party requestors on behalf of a parent or guardian. The collection form, data, and signature (when required) are automated and electronically stored to avoid paper record handling. It is utilized throughout the LA LINKS public health units.

A new form is generated and stored every time a record is picked up in the clinic. Up to three receivers can be entered in advance for a patient.

This is a two-page form. The second page of the form is also available from Reports > State Reports in the menu, which can be printed and distributed to requestors. Additionally, there is a report listing patients that have requested records, when the requests were made, and by whom.

From the Patient Demographics page, click the Launch 402P Form button. The 402P Form page opens. Enter the information and, if needed, print the page with the browser's print option.

Related topics:

• 402P Form (Report)
• Health Information Requests
• Patients
• Search for Patients
• Add/Edit Patient Records
• Edit Programs and High Risk Categories
• Waiting Room
• School Nurse Module Patient Detail
• Child Care Module
• Remote Registry
• Insurance Information
• Patient Encounter Information

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