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EXHIBIT 320U5 AFFIDAVIT (PURSUANT TO A.R.S. 36533) STATE OF ARIZONA COUNTY OF)) SS)), being first duly sworn, deposes and says: 1. 2. 3. That affine is a physician and is experienced in psychiatric
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Step 1: Start by downloading the DBHS form MH-112doc from the official website.
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Who needs dbhs form mh-112doc?

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DBHS form MH-112doc is required by individuals or patients who are seeking mental health services from the Department of Behavioral Health Services (DBHS).
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Medical professionals, therapists, counselors, or any mental health service providers may also need this form to document and assess the patient's condition and treatment needs.
03
Families, caregivers, or legal guardians of individuals receiving mental health services may be required to fill out this form on behalf of the patient.
04
It is important to consult with the respective mental health facility or DBHS for specific guidelines on who needs to fill out this form.
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dbhs form mh-112doc is a document used by the Department of Behavioral Health Services to collect information about mental health services provided.
Healthcare providers and facilities that offer mental health services are required to file dbhs form mh-112doc.
dbhs form mh-112doc can be filled out electronically or manually, with information on the type and frequency of mental health services provided.
The purpose of dbhs form mh-112doc is to ensure accurate reporting and tracking of mental health services for improvement and planning purposes.
Information such as the type of services provided, number of patients served, and demographic data of patients must be reported on dbhs form mh-112doc.
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Relevant keywords

2016 ARIZONA DSM deposes affiant Cognition inpatient impairs impair hospitalization Persistently impairment evidenced acutely ADDENDUM SUBSCRIBED disadvantages PURSUANT treatable outpatient substantially Notary significantly thereof Expires Gravely Physic

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