Hfs 3411C Form PDF Details

The HFS 3411C form serves a crucial function within the healthcare framework of the State of Illinois, specifically tailored for Advance Practice Nurses (APNs). This form is designed by the Department of Healthcare and Family Services and encompasses a comprehensive set of information that APNs must provide. This includes personal and professional details such as name, contact information, license number, and provider number. Moreover, it encompasses critical areas of specialization, highlighting the diverse roles APNs can hold, including Certified Nurse Midwives, Certified Registered Nurse Anesthetists, Certified Nurse Practitioners, and Clinical Nurse Specialists. Each category allows specification of further specialties, exemplifying the form's role in cataloging the varied expertise within the nursing field. In addition to certifying their qualifications, APNs are required to detail collaborative agreements with physicians, unless exempt, as in the case for some Certified Registered Nurse Anesthetists. Such collaborations are an integral part of nursing practice, ensuring comprehensive patient care through interdisciplinary teamwork. The form also includes a certification statement that underscores the APN's commitment to maintaining the accuracy of their professional information and understanding the obligation to update the Department with any changes. With a clear directive for submission and contact information for further assistance, the HFS 3411C form underscores the structured and regulated environment within which APNs operate, ensuring that their practice is not only certified but also integrated within the broader healthcare system of Illinois.

QuestionAnswer
Form NameHfs 3411C Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameshfs3411c hfs 3411c n 3 06 form