DIRV Articles and Forms

Fire safety in your RV is important because there are so many ways a fire can occur. Minimizing RV fire risks should be a top priority. This is more than just making sure that fire detectors and extinguishers are operating as designed. Fire safety document plus fire safety checklist.

Patient information, emergency contact, employer, insurance, current medical problems, obstetric and gynecological history, surgical history, allergies, medications, past medical history, family history, education; tobacco, alcohol, caffeine, drug use; financial policy and authorizations, consent to contact, notice of privacy practices, patient communication consent, disclosure to family members.

A form with medical history, surgical history, hospitalizations, family history, social history, medications, allergies, immunizations.

A form with medical history, ob/gyn history, surgical history, hospitalizations, family history, social history (alcohol, tobacco, etc), medications, allergies, immunizations, health maintenance and screening tests, review of systems.

Don't Panic, You Now Have the Important Information at Your Fingertips! This form may be the most important form in your RV. It contains vital information needed in event of an emergency.

A medical record release authorization. This form is to obtain a copy of your medical record or to have a copy sent to your physician or the person of your choice.

Patient information, name, address, date of birth, emergency contact, pharmacy, marital status, employer, gender, etc.

Medical Contact Information Form

Medical contact form contains name, address, phone information of physicians, pharmacies, hospitals and clinics and emergency contacts.

Medical Demographics and History Form

Information on patient, guarantor, pharmacy, insurance, surgical history, past medical history, family history, education, use of tobacco, alcohol, caffeine, drugs; obstetric/gynecological history, consent to contact, communication preferences, disclosure to family members, privacy practices.

 All of the new patient forms are similar with some small changes

New Patient Dental Form

Patient information, guarantor, emergency contact, payment information, dental history, medical history, illnesses and symptoms, allergies, agreement.

Communication Consent Form

A form with notice of privacy practices, communication consent, disclosure to family members.

Patient Demographics Form

Patient information, name, address, birthday, gender, marital status, employer name, insurance information, insurance, HIPAA acknowledgment and consent form.

New Pediatric Patient Form - 6 years and up

Pediatric form for children 6 years of age and up. Patient information, birth history, medical history, family medical history, authorization for consent to medical care and treatment.

New Pediatric Patient Form - Newborn to 6 years

Pediatric form for children from newborn to 6 years of age. Patient information, birth history, medical history, family medical history, social history, authorization for consent to medical care and treatment.

This form expands on the blood sugar form with the addition of blood pressure, pulse, respirations, and temperature.

Medical and Systems Review

This form contains extensive information. Completing this form prior to your medical visit will eliminate many questions you are asked. This form contains name, date of birth, past history, pregnancy history, immunization history, previous hospitalizations, surgery history, family history, social history, occupation, education, marital status, habits, medications, allergies, and a review of systems which contains many of the questions your doctor would ask.

New articles and forms will be listed here when release.

New articles and forms will be listed here when release.

New articles and forms will be listed here when release.

RV Injuries
Dangers of the Dump Zone
Old deteriorating RVs
RV Slides Injuries
Snakebites, Bug Bites, Ant Bites
Allergic Reactions
Lightning Strikes
Infections
Pulse Oximeter Use
Oxygen and Oxygen Tanks
First Aid Kit Contents
The Black Tank - Sewage Drainage and Infections
Battery Safety
Exercise
Goal Zero Use
CPAP Machine
Water Filters
Air Quality and Filters
Fever Chart
Pet food safety
Child Proofing your RV
Cold and Hot Weather Illnesses
Medications
Lakewater Health Risks
Tourniquets Uses
Flammable Household Products