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STATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES Initials MENTAL HEALTH COMPONENT PROGRAM AUDIT WORKING PAPER (SR 2CWP) PROVIDER NAME: Date Prepared By
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How to fill out initials date mental health:

01
Start by entering the current date in the "Date" field of the form.
02
Then, provide your initials in the designated space. These should be your first name, middle initial (if applicable), and last name initials.
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Make sure to accurately represent your initials to avoid any confusion with other individuals.

Who needs initials date mental health?

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Individuals seeking mental health services or treatment are required to fill out the initials date mental health section.
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This is typically a standard practice in mental health clinics, hospitals, therapy sessions, or any other mental health facility.
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The initials date mental health helps in identifying and documenting the individual's agreement or consent to receive mental health services or treatment.
Note: It is essential to consult the specific guidelines or instructions provided by the mental health facility you are visiting, as the process may vary slightly depending on the organization.
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