First-time reference of an abbreviation or acronym

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When an abbreviation is uncommon or rarely recognized, or when it represents an acronym of the name of an organization or local reference, it should be spelled out in full when first referenced, even if dictated as an abbreviation. Include the abbreviated form in parentheses after the expanded reference and then use the abbreviated form consistently throughout the rest of the document. Do not abbreviate the term if dictated in full elsewhere in the document.

D: The patient was referred to SHMC for admission.
T: The patient was referred to Stanford Hospital Medical Center (SHMC) for admission.

D: The patient's family understands the HRQOL issues. Should the HRQOL deteriorate, they are prepared to make further decisions.
T: The patient's family understands the health-related quality of life (HRQOL) issues. Should the HRQOL deteriorate, they are prepared to make further decisions.