Residential Care for the Elderly (RCFE) Physician's Report
All prospective RCFE residents must have a doctor fill out a RCFE/ARF Physician's Report (602) which is given to the RCFE owner. One part of the report requires a TB test or chest x-ray within 6 months. The form requires two signatures: from the PCP and from the resident/patient or their authorized representative.
The printable version of the Physician's Report (602) is here.
Please note Connections does not need this document unless it is part of the CalAIM Referral Package.
For CalAIM, if you would like to use our Physician’s Report (602) Adobe Sign Version, please have the PCP or their office fill out the request form below and we will send it to the appropriate parties: first, to the PCP to fill out and sign and, once we receive it, to the patient/resident or to their authorized representative for their signature. Once the form is complete all parties, including Connections, will receive the signed copies. Please note this request form is only for the PCP or their office for the CalAIM Program.
