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نماذج - تقرير طبي - نموذج علاج بالخارج - اجازة مرافق مريض

حديد

تقرير طبي - نموذج علاج بالخارج - اجازة مرافق مريض - حجز موعد في الخارج للمرضى - جلسات غسيل الكلى في الخارج - طلب تأجيل موعد السفر للعلاج - طلب تغيير جهة العلاج - طلب موعد تظلم على قرار اللجنة العليا للعلاج بالخارج أو اللجنة الطبية لتقدير اللياقة الطبية والعجز - طلب نسخة من التقرير الطبي (من جهة العلاج) - طلب اعتماد اجازة مرضية للمريض العائد من الخارج .

therapy-report-abroad

تحميل نماذج و استمارات طبية حكومية فقط اضغط على الملف للتحميل

م	النموذج
1.	استبيان جودة الخدمة
2.	طلب كتاب عودة
3.	طلب كتاب مغادرة
4.	طلب اعتماد اجازة مرافق بدون مخصصات مالية للمرضى الذين صدرت لهم موافقة علاج على نفقة الدولة
5.	بيانات خاصة واقرار
6.	تعهد اثبات عدم زواج
7.	طلب الحصول على رأي اخر من الخارج
8.	طلب تقديم خدمة استقبال وترجمة وحجز موعد في الخارج للمرضى الذين على حسابهم الخاص
9.	طلب تغطية تكاليف جلسات غسيل الكلى في الخارج
10.	طلب تأجيل موعد السفر
11.	طلب تغيير جهة العلاج
12.	طلب موعد تظلم على قرار اللجنة العليا للعلاج بالخارج أو اللجنة الطبية لتقدير اللياقة الطبية والعجز
13.	طلب عرض على اللجنة العليا
14.	طلب نسخة من التقرير الطبي ( من جهة العلاج )
15.	طلب اعتماد اجازة مرضية للمريض العائد من الخارج
16.	الطلبة

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