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HEALTH SYSTEM

Printing and Copying Services is the official printer of hospital forms,
patient education / information materials and stationery.

Click on the links to the left below to place your order online.

Questions to consider before ordering a Form or Education Materials
from Printing & Copying Services


1. Is this a form that already exists in the Medical Record? Yes or No
• If Yes, any changes must be approved by Clinical Forms Committee (Call 924-2196).For more information about forms approval or approved abbreviations see:
https://www.healthsystem.virginia.edu/intranet/HIS/home.cf

2. Is this a form that is to become part of the Patient's Permanent
Medical Record?
Yes or No
• If Yes, has the form been approved by the Clinical Forms Committee? Yes or No
• If Yes, What Medical Record Category has been given by the Committee?
Number and Category: __________________
• If No or questions, direct requestor to Clinical Forms Committee, 924-2196

3. Is this material to be used for Discharge Instructions? Yes or No
• If Yes, will the instructions be customized for the patient? Yes or No
• If Yes, these will be on a NCR UVa Form with Barcode and included in the chart.
• If No, it will be put on the UVa Pt Ed Template, not included in the chart and will need a number assigned by Office of Patient and Family Education. Direct requestor to Cindy Westley, cjw2s@eduvirginia. or 924-5724.

4. Is this material to be used for Patient Education? Yes or No
• If Yes, and is a new or revised piece, has the Office of Patient and Family Education given an identifying number? Yes or No Please note: any identifying numbers on materials before January 2006 is out of date - new numbers start with a category number and no longer have PEME?
• If No or questions, direct requestor to Cindy Westley, cjw2s@virginia.edu or 924-5724

5. Is this material a translation to another language? Yes or No • If Yes, has it been approved by Language Assistance Services? Yes or No
• Only English materials will be put into the patient's medical record. Forms must be formatted based on the Formatting Guidelines below.**
• If No or questions, direct requestor to Sally LeBeau, sbs5h@virginia.edu or 924-9244

6. Does the material have any other logo/graphic element besides or in addition to the official UVaHS logo Yes or No (Note: Templates exist for "Fact Sheet", "Pt Info/Handbook" and "Pt Info Shell". If there is any question about the use of the material contact Reecye Modny. )
• If Yes, has Marketing approved?
• If No or questions, direct requestor to Reecye Modny, rfm9g@virginia.edu or 924-0366

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Last Modified: Wednesday, 04-Nov-2009 14:14:40 EST
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