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Autodeclaración: formulario de muestra

Year Developed: 2017

Resource Type: Template .

Primary Audience: Administrative Staff
Secondary Audience: Enabling Services

Language(s): Spanish

Developed by: National Center for Farmworker Health (See other resources developed by this organization).

Resource Summary: Modelo de formulario de autodeclaración del paciente. La autodeclaración es un mecanismo práctico para documentar los ingresos familiares y el tamaño de la familia para las personas que tienen dificultades para mostrar otros documentos.

Resource Details: This resource is in Spanish.

Resource Topic: Special and Vulnerable Populations,

Resource Subtopic: Patient-Centered Health Outcomes, Patient Engagement, Population Health, Program and Services.

Keywords: Agricultural Workers , Hispanic Americans/Lations, Latinas , Access to Care.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.