Other Service Information Sample Clauses

Other Service Information. D.1 Other Information The Housing Support Provider is to provide information on service planning and policy implications if requested by the Owner. This information may include, but is not limited to information on new or unmet needs, service gaps, business processes, innovations in service delivery, policy review options, and systems issues. Attachment 8: Reportable Incident Form This form is to be completed and sent to xxxxxxx.xxxxxxxx@xxxxx.xxx.xxx.xx Organisation Details Organisation Service Contact Person Contact Person’s Position Contact Person’s Phone Number Consumer Information Details of the consumer affected by this incident. Last Name First Name Gender Date of Birth Address Is the consumer subject to any legal orders? (If Yes, please Specify) Incident Details Details of when and where this incident occurred. Location of Incident Incident Incident Date Time Reported By Position Witnessed By Position Notifications Who has been notified about this incident (Police, ambulance, family etc.)? Name / Relationship Time and Date Name / Relationship Time and Date Name / Relationship Time and Date Incident Type Please indicate the nature of the incident that occurred (type of injury, cause/s of injury). Specific Incident Details Please provide a clear, factual summary, including any contributing factors to the incident. Actions Taken What actions were taken immediately following the incident? Further Planned Actions What actions will be taken next? Name of Person Completing this Form Signature Position Date
Sample 1
AutoNDA by SimpleDocs
Other Service Information 
Sample 1Sample 2Sample 3See All (7)

Related to Other Service Information

  • Service Information Service Visit Date Mode of service Face-to face, telephone, etc. Responsibility for payment Used to exclude federal govt., WCB, etc. Main and secondary diagnoses ICD10-CA codes Main and other interventions and attributes CCI procedure codes and attributes Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) Doctor name and identifier Physician specific information Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance Institution from and institution to Used when a Client is transferred from or to another acute care facility Visit disposition Discharged, admitted, left without being seen, etc. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information Province Client‟s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information Facility Code AHS provided code that indicates service being provided. Facility Fee Dollar value of service being provided Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3

  • Voice Information Service Traffic 5.1 For purposes of this Section 5, (a) Voice Information Service means a service that provides [i] recorded voice announcement information or [ii] a vocal discussion program open to the public, and (b) Voice Information Service Traffic means intraLATA switched voice traffic, delivered to a Voice Information Service. Voice Information Service Traffic does not include any form of Internet Traffic. Voice Information Service Traffic also does not include 555 traffic or similar traffic with AIN service interfaces, which traffic shall be subject to separate arrangements between the Parties. Voice Information Service Traffic is not subject to Reciprocal Compensation charges under Section 7 of the Interconnection Attachment.

  • Service Information Pages Verizon shall include all VarTec NXX codes associated with the geographic areas to which each directory pertains, to the extent it does so for Verizon’s own NXX codes, in any lists of such codes that are contained in the general reference portion of each directory. VarTec’s NXX codes shall appear in such lists in the same manner as Verizon’s NXX information. In addition, when VarTec is authorized to, and is offering, local service to Customers located within the geographic area covered by a specific directory, at VarTec’s request, Verizon shall include, at no charge, in the “Customer Guide” or comparable section of the applicable alphabetical directories, VarTec’s critical contact information for VarTec’s installation, repair and Customer service, as provided by VarTec. Such critical contact information shall appear alphabetically by local exchange carrier and in accordance with Verizon’s generally applicable policies. VarTec shall be responsible for providing the necessary information to Verizon by the applicable close date for each affected directory.

  • Notice Information Notices will be sent: If to LESSOR: INTERNATIONAL LEASE FINANCE CORPORATION 1999 Avenue of the Stars, 00xx Xxxxx Xxx Xxxxxxx, Xxxxxxxxxx 00000, X.X.X. Attention: Legal Department Fax: 000-000-0000 Telephone: 000-000-0000 If to LESSEE: AMERICAN TRANS AIR, INC. 0000 Xxxx Xxxxxxxxxx Xxxxxx Indianapolis International Airport Xxxxxxxxxxxx, Xxxxxxx 00000 Xxxxxx Xxxxxx of America Attention: Xxx Xxxxx Executive Vice President and Chief Financial Officer Fax: 000-000-0000 Telephone: 000-000-0000 or to such other places and numbers as either party directs in writing to the other party.

  • Submission of Grievance Information a) Upon appointment of the arbitrator, the appealing party shall within five days after notice of appointment forward to the arbitrator, with a copy to the School Board, the submission of the grievance which shall include the following:

  • False Information The Borrower or any Obligor has given the Bank false or misleading information or representations.

  • - CLEC INFORMATION CLEC agrees to work with Qwest in good faith to promptly complete or update, as applicable, Qwest’s “New Customer Questionnaire” to the extent that CLEC has not already done so, and CLEC shall hold Qwest harmless for any damages to or claims from CLEC caused by CLEC’s failure to promptly complete or update the questionnaire.

  • Disclosure to numbering service providers (a) Any Finance Party may disclose to any national or international numbering service provider appointed by that Finance Party to provide identification numbering services in respect of this Agreement, the Facility and/or one or more Obligors the following information:

  • Client Information (2) Protected Health Information in any form including without limitation, Electronic Protected Health Information or Unsecured Protected Health Information (herein “PHI”);

  • Verizon OSS Information 8.5.1 Subject to the provisions of this Section 8, in accordance with, but only to the extent required by, Applicable Law, Verizon grants to CBB a non-exclusive license to use Verizon OSS Information.

Time is Money Join Law Insider Premium to draft better contracts faster.