TISS76-Form

The File:TISS76-FORM for ICU citywide2.pdf is the standard form we use to collect TISS76 data.

• For information on how to fill out this form, see: ! TISS76 Collection Guide.

• The TISS form is sent in main office and scanned by the Data Processor using a program called Teleform.

• The form needs to be ordered via the Main Office because exact reproduction is required for the scanning program to correctly scan these forms.