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Palms West Hospital
Pediatric ER

EMTALA Attestation Form

I certify that I have completed the required EMTALA training and agree to abide by the laws of EMTALA. I understand that to receive treatment at Palms West Hospital:

  • All patients must be registered
  • All patients must be triaged
  • All patients must be entered into the central (EMTALA) log
  • All patients must have a medical record
  • All patients must have a hospital arm band
  • All patients registered and triaged through the Emergency Department must have a medical screening exam