for NEW LNC's

Pittsburgh Chapter members have contributed samples of their work products to develop a wonderful tool for the new LNC or an experienced LNC looking for new ideas. Rather than reinvent the wheel, you can tailor letters of introduction, LNC reports, LNC bills, and more, to meet your personal needs.

Pittsburgh Chapter "Sample Forms" booklets are available through our chapter membership office. Please contact Kathy Seapker at (412) 939-3426 or at kesrehab@aol.com for more information

AALNC Pittsburgh Chapter Membership Application

MEMBERSHIP APPLICATION (1).doc

Table of Contents - Sample Forms Booklet

(1) FACSIMILE COVER LETTERS
(2) FEE SCHEDULES
(3) EXPERT CONSULTATIVE SERVICE FEES FORM
(4) CASE TRACKING FORM
(5) TIME/BILLING FORMS
(6) INVOICES
(7) EMPLOYEE CAREER DEVELOPMENT ASSESSMENT FORM
(8) FACILITY RESEARCH FORM
(9) RECORDS RELEASE FORM
(10) JOB ANALYSES
(11) INFORMATION TRANSFER FORM
(12) MARKETING LETTER
(13) ENGAGEMENT LETTER
(14) REFERRAL LETTER
(15) EXPERT LETTERS
(16) TIME LINES
(EXAMPLE 1) CASE CAPTION
(EXAMPLE 2) TIME LINE OF PLAINTIFF MOM IN LABOR
(EXAMPLE 3) PLAINTIFF SYMPTOMS/COMPLAINTS
(EXAMPLE 4) IDENTIFICATION OF ALL DEFENDANTS AND DATE/TIME OF INTERVENTIONS
(17) LIFE CARE PLANNING AREA COST ANALYSIS REQUEST
(18) HIPAA FORMS
(EXAMPLE 1) AUTHORIZATION FOR THE RELEASE OF INFORMATION
(EXAMPLE 2) AUTHORIZATION FOR THE RELEASE OF MEDICAL INFORMATION
(EXAMPLE 3) CONFIDENTIALITY AGREEMENT