Table of Contents: Supporting Documents

The policies in this section have been vetted through the review and approval process in accordance with The University of Texas Medical Branch at Galveston’s Institutional Handbook of Operating Procedures (IHOP), established under the guidelines of The University of Texas System, Board of Regent’s Rules.
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IHOP  -  Supporting Documents
Adult Primary Care Prescription Refill Guidelines for Ambulatory Services
Alternative Process for Site Marking
Competent
Cover sheet re misdirected fax new logo
CRC -Log of Procedures (Muscle Biopsy)
CRC -Privilege Delineation Form (Muscle Biopsy)
Crime Prevention and Education Programs
Definitions
Departmental Certifications 10-10-11
Designated Operative and Invasive Procedure
Disposable Income Worksheet
DOT behavior sheet
Email Agreement
Email Tracking Tool
Examples of hospital areas that are not open to the public prohibited to service animals
Faculty CV template
Faculty or Staff Organization Registration Form
FAIR USE definition
Federal Poverty Index
FINANCIAL CLASSIFICATION OF P AND V
Financial Indigent Requirements and Application Process
FOAM Guidelines re Signage
GNL Photography Policy
Guidelines for Registered Faculty or Staff Organizations
GYN ONC Clinical Trials
HBConfirmation
HBsAg_screening
Health System Departmental Certifications
Hotel Tax Exempt Certificate
IBS definition
ICC Repeal Request
IHOP - 02.01.05 - Business Continuity Plan
IHOP - 02.06.06 - Posting of Notices on Institutional Communication Venues
IHOP - 02.06.07 - Fundraising Projects Benefiting UTMB Budget Worksheet (sample)
IHOP - 02.06.07 - Fundraising Projects Benefiting UTMB Proposal Form
IHOP - 02.07.02 - Space Mangement Research Policy Attachment to Amendment
IHOP - 02.07.02 - Space Request Process and Form
IHOP - 02.17.07 - Wikipedia Examples
IHOP - 02.19.07 - Use of Social Media (Tips)
IHOP - 03.07.08 - Worksite Breastfeeding Lactation Room Guidelines
IHOP - 03.07.13 - Reduction in Force (RIF) Criteria
IHOP - 03.07.13 - Reduction in Force (RIF) Guidelines1
IHOP - 03.07.13 - Reduction in Force (RIF) Guidelines2
IHOP - 04.04.17 - Membership Organization Dues (Chart) Duplicate
IHOP - 04.04.17 - Membership Organization Dues - (Chart)
IHOP - 04.05.07 - Cost Sharing Policy (Accounting Treatment for Cost Sharing)
IHOP - 05.03.08 - Grievance Panel Hearing Procedures
IHOP - 05.03.14 - Faculty Ombudsperson Policy (Position Description)
IHOP - 05.07.05 - Policy on Integrity in Research - Assessment, Inquiry and Investigation Procedures Manual
IHOP - 06.02.01 - Authorization Validation Checklist
IHOP - 06.02.01 - Use and Disclosure of PHI Based on Patient Authorization (Form)
IHOP - 06.02.01 - Use of Disclosure of PHI Based on Patient Authorization (Elements)
IHOP - 06.02.09 - Fax Transmittal of PHI (Cover Letter)
IHOP - 06.02.24 - Removal of Protected Health Information from UTMB Facilities (Request for Use of PHI Offsite Form)
IHOP - 06.03.09 - Details Outpatient ABN
IHOP - 07.01.01 - Appendix A
IHOP - 07.01.01 - Appendix B
IHOP - 07.01.01 - Appendix C
IHOP - 07.01.01 - Appendix D
IHOP - 07.01.01 - Appendix E
IHOP - 07.01.01 - School of Nursing Essential Functions
IHOP - 07.01.01 - Student Request for Accommodations
IHOP - 07.01.03 - Documentation of Non Academic Concerns
IHOP - 07.01.10 - Student Accident and Injury Reporting (Form)
IHOP - 07.01.13 - Documentation of Non Academic Concerns Form
IHOP - 07.01.20 - SHP Grading and Evaluation
IHOP - 07.01.20 - SHP Student Appeals of Grading and Unsatisfactory Academic Performance (Grievance Steps)
IHOP - 07.01.29 - UTMB Student Health Inaurance Policy (Acknowledgement Form)
IHOP - 08.01.01 - Policy and guidelines on AIDS, HIV and Hepatitis B (TCPHP Testing of Pregnant Women)
IHOP - 08.01.02 - OGG feedback Safe Patient Handling
IHOP - 08.01.05 - Fire Alarm and Incident Response Policy (Drills)
IHOP - 08.01.05 - Fire Alarm and Incident Response Policy (Response)
IHOP - 08.01.23 - Above Ceiling Work Policy for Healthcare Buildings (Permit)
IHOP - 08.02.01 - Threatening Situtations (Activating the Alert System)
IHOP - 08.02.07 - Security Associated with Offender Correctional Patients
IHOP - 09.01.32 - Process for Testing Dr. Pink System
IHOP - 09.02.06 - MED-REQ
IHOP - 09.02.06 - Research Request form
IHOP - 09.02.07 - Use and Disclosure of Inpatient Protected Health Information (Discharge Needs Assessment Factors)
IHOP - 09.02.08 - Medial Record Forms Management (Guidelines) doc 2007
IHOP - 09.02.08 - Medical Record Form Management (Guidelines)
IHOP - 09.02.15 - Medical Record Documentation (Guidelines for Copying Pasting Medical Records)
IHOP - 09.02.15 - Medical Record Documentation (Style Guide)
IHOP - 09.02.15 - Medical Record Documentation (Style Guide) Duplicate
IHOP - 09.02.16 - Scanning Protected Health Information to Epic (Do's and Don'ts of Scanning)
IHOP - 09.02.20 - Email Agreement
IHOP - 09.02.21 - Medical Record Number Assignment (Tips)
IHOP - 09.03.02 - Use of Photgraph, Video Audio Recordings and or Televising Patients (Consent Form)
IHOP - 09.03.04 - Law Enforcement Request for Records (SANE)
IHOP - 09.03.04 - Texas Department of Family and Protective Services p1
IHOP - 09.03.09 - Assessment Criteria
IHOP - 09.03.09 - Definitions - Abuse Neglect and Exploitation of Elderly or Disabled Persons
IHOP - 09.03.09 - Definitions of Child Abuse and Neglect
IHOP - 09.03.09 - Examples LINK
IHOP - 09.03.09 - Reporting Suspected Abuse, Neglect, and Exploitation of Children, the Elderly and or Disabled Persons (Assessment Criteria)
IHOP - 09.03.32 - SBS Medical_Disclosure_English
IHOP - 09.03.32 - SBS Medical_Disclosure_Spanish
IHOP - 09.08.02 - UTMB Health Charity Care and Financial Assistance Policy (Asset Procedure)
IHOP - 09.11.04 - Standing Delegated Order Flow Diagram
IHOP - 09.13.04 - POCT Responsibilities
IHOP - 09.13.10 - Changing Patient Identifiers
IHOP - 09.13.10 - Changing Patient Identifiers - Attachment A
IHOP - 09.13.10 - Changing Patient Identifiers - Attachment B
IHOP - 09.13.10 - Changing Patient Identifiers - Attachment C
IHOP - 09.13.10 - Changing Patient Identifiers - Attachment D
IHOP - 09.13.22 - Medical Equipment Plan (EOC) Master_Plan
IHOP - 09.13.32 - Admission Decision Tree
IHOP - 09.13.32 - Exclusion Criteria1
IHOP - 09.13.32 - Inclusion Criteria
IHOP - 09.13.35 - ANTICOAGULATION DISCHARGE ORDERS (3004003)
IHOP - 09.13.35 - Anticoagulation Follow-Up (26015)
IHOP - 09.13.35 - Anticoagulation for ACS ORDER SET-No Renal Failure (CrCl greater than 30ml min) (522)
IHOP - 09.13.35 - Anticoagulation for ACS ORDER SET-No Renal Failure (CrCl LESS than 30ml min) (521)
IHOP - 09.13.35 - Anticoagulation for DVT PE Order Set -Renal Failure (CrCl less than 30 mL min) (524)
IHOP - 09.13.35 - Anticoagulation for DVT PE ORDER SET-No Renal Failure (CrCl LESS than 30ml min) (523)
IHOP - 09.13.35 - Anticoagulation Initial (26014)
IHOP - 09.13.36 - OSA Screening Tool
IHOP - 09.13.37 - Tube Placement for Nutrition in Adults
IHOP - 09.13.39 - Humpty Dumpty Fall Assessment Scale
IHOP - 09.13.39 - Patient Falls Prevention Plan
IHOP - 09.13.40 - Blanket and Fluid Warmer Operating Temperatures (Guidelines)
IHOP - 09.15.01 - Disposition of Deseased Patients (Autopsy Services)
IHOP - 09.15.05 - Patients Initiating Advance Directives (Witnesses)
IHOP - 09.19.03 - Mobile Communication Devices Policy (Cellular Lease)
IHOP - 10.01.01 - Academic Program Evaluation (Critical Thinking Chart)
IHOP - 10.01.02 - UTMB Approval Process for New Educational Programs (Flow Diagram)
IHOP - 11.01.05 - Research Related Injury (Addendum A)
IHOP Policies that delineate professional behavior
IHOP process
IHOP Process Diagram-Visio
IHOPdiagram
Illegal Drugs and Alcohol Use and Abuse
IncomeCalculationDocWorksheet
IncomeTaxProc
Inpatient Nursing Admission Assessment- Criteria for further assessment (4)
Intraosseous (IO) Overview
IP HEM ARGATROBAN WEIGHT-BASED DOSING FOR HIT (3000090)
LD Access Request Form
Longevity Pay Schedule
MediaAuthorization
MediaAuthorizationSpan
Medical Examiner
Medical Indigency worksheet
Medically Indigent Notification Letter
Month income calculation
Morse Fall Assessment Scale
OCRLetterviolence-1
Off unit log
Outbreak of Hep A
Pager Lease
PASS
Patient dismissal letter A14
Patient Owned Medical Equipment CES form
PATIENT PLACEMENT FORM
Patient Services Complaint Process 2009
PG-Priority Index Definition
Policy Template
Postmortem Anatomical Gifts
PP COBRA Premiums Paid by UTMB
Pre-existing Conditions of Primary Interest
Procedure for Clinical Assessment of Brain Death
Professionalism Agree Final
RACE
Reduction in Force Guidelines
Registration for Eligibility of 3rd party Resources
Release of Forensic Photographs
Request for Dual Employment
Request for Non-IHOP Review
Request for Policy Review
Request for Use of PHI Offsite
Resource Conservation Guidelines
Restraint Comparison Table
Restraint Algorithms
Reversal of Anticoagulation-No indications for SQ adminisration of Vitamin K (525)
RMCHP 13. 7 Domestic Violence
Roles and Responsibilities - Deceased Patients
RTOG Active and Pending Protocols CAMPUS
Screening Criteria for Communicable Diseases
Sexual Assault Prevention and Response
Space Planning Process (2013)
SUBCHAPTER C Texas Public Information Act Exceptions
Supervisor's Observation Report
Sutainability Steering Committee ReportJune 30REVISED (2)
TDP3 4BDonorVerificationForm
Telecommunications Services Request
Texas Administrative Code CHAPTER 21 Student Services
The certification process
Timely Warnings, Emergency Notifications and Evacuations
Toluidine Blue Dye
TRAUMA TEAM ACTIVATION GUIDELINES
UT SYSTEM POLICY ON SUSTAINABILITY PRACTICES-Assignments
UTMB Campaign Counting Guidelines
UTMB Health authorization for the release of photos
UTMB Health consent to photograph for TPO
UTMB Healthcare Buildings
UTMB Patient Absence Request Form 05PA
UTMB SPACE GUIDELINES
Vendor Procedures
Vendor Release Form
Vendor Visitation Form
Verification Letter Various Scrubs
Verifying Treatment Relationship Checklist
Victory Lakes Surgical Center Consent Form
Violation of Policy paragraph
Who Are UTMBs Campus Security Authorities

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with few exceptions, may not be used, distributed, or reproduced outside of UTMB without written permission.
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