Attachment F.docx
DOCX document 65 KB Posted
- Attached to
- Q999 - VISN 12 Home Oxygen Delivery Services
- Solicitation number
- 36C25225R0072
About this file
Attachment F is a Smoking Risk Acknowledgement Form (SRA) for VA 1624 Clinical Respiratory Assessment related to the VISN 12 Home Oxygen Delivery Services solicitation. The form appears to be a standard medical risk documentation template, specifically designed for a clinical respiratory assessment, and was last revised on 6/4/2020. While the file itself does not contain substantive contract details, it is linked to a solicitation (Solicitation Number: 36C25225R0072) for home oxygen delivery services covering multiple Veterans Affairs medical facilities across Wisconsin, Michigan, and Illinois, including locations in Milwaukee, Madison, Tomah, Iron Mountain, North Chicago, Hines, Chicago, and Danville.
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Other files
| File | Type | Posted |
|---|---|---|
| P07 - Lake County WD 2015-4935 Rev 28 07.08.2025.pdf | ||
| P07 - Dane County WD 2015-4897 Rev 29 07.08.2025.pdf | ||
| Attachment K.docx | DOCX document | |
| Attachment J - 1.docx | DOCX document | |
| Attachment J - 2.docx | DOCX document | |
| Attachment D.docx | DOCX document | |
| S02 - 36C25225R0072.pdf | ||
| P07 - Monroe County WD 2015-4929 Rev 29 07.08.2025.pdf | ||
| P07 - Cook County WD 2015-5017 Rev 30 07.08.2025.pdf | ||
| Attachment B - 1.docx | DOCX document | |
| Attachment H.docx | DOCX document | |
| Attachment B - 2.docx | DOCX document | |
| Attachment E - 2.docx | DOCX document | |
| Attachment E - 1.docx | DOCX document | |
| P07 - Dickinson County WD 2015-4871 Rev 30 07.08.2025.pdf | ||
| P07 - Vermillion County WD 2015-5021 Rev 26 07.08.2025.pdf | ||
| Attachment A.docx | DOCX document | |
| Attachment I.docx | DOCX document | |
| Attachment G - 1.docx | DOCX document | |
| Attachment C.docx | DOCX document | |
| P07 - Milwaukee County WD 2015-4899 Rev 28 07.08.2025.pdf | ||
| Attachment G - 2.docx | DOCX document |
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Text version
Attachment F – Smoking Risk Acknowledgement Form (SRA)
VA 1624 Clinical Respiratory Assessment – Vent (VISN 12) Rev 6/4/2020 image1.png
File details come from the government source that posted it. Updated .