Ethic Committee

Emergency Plan

Same month every year (annually)

Complete the Data Sheet.

Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)

Your License must be renewed every 2 years

Renew License Form: 60 days before to expiration date.    CLIA application form

Annual Minutes of Ethic Committee meetings

The following templates, must be used as Agenda for your meeting, the Administrator and DON must assure that the meeting was done with acceptable quorum, and active participation of each member of the committee.

Members: Administrator, DON, Alt. Administrator, MSW

Regular annual minute:

Ethic Meeting Minutes

Ethic Incident Report (If any):   Ethic Incident Report

Disclaimer: Every template is only your guide/AGENDA to type the Minutes of your meeting, your Agency Officials must assure that the meeting occur, the quorum is acceptable, and every member had active participation in the discussion