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STATE OF HAWAII Department of Human Services PATIENT'S NAME: (Last Name, First, M.I.) READMISSION SCREENING ANNUAL RESIDENT REVIEW (PAS/RR) LEVEL I SCREEN PART A: 1. SERIOUS MENTAL ILLNESS (SMI):
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How to fill out 1178 form:

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Begin by obtaining a copy of the 1178 form from the relevant authority or organization that requires it. It can usually be downloaded from their website or obtained in person.
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Read all the instructions provided on the form carefully to understand what information needs to be filled out and any specific guidelines or requirements.
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Start by providing your personal information such as your name, contact details, and any identification numbers or references required, as indicated on the form.
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Sign and date the form at the designated space to indicate your agreement and confirmation of the information provided.
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Keep a copy of the filled-out form for your records before submitting it to the designated authority or organization as per their instructions.

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Please note that the specific requirements or instances where the 1178 form is needed can vary depending on the jurisdiction, organization, or purpose. It is important to follow the instructions and guidelines provided by the relevant authority to ensure the form is properly filled out and submitted.
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1178 form is a form used for reporting certain financial transactions to the IRS.
Entities or individuals that have engaged in reportable financial transactions are required to file 1178 form.
1178 form must be filled out with accurate information regarding the financial transactions being reported.
The purpose of 1178 form is to provide the IRS with information on reportable financial transactions.
The information reported on 1178 form includes details of the financial transactions, such as amounts, dates, and parties involved.
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