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Separated 2. Married 5. Divorced/ Annulled 3. Widowed 5. Education check last grade completed 23 00 None 11 11th grade 01 1st grade 12 12th grade 02 2nd grade 13 Voc/Tech/Bus Schl 03 3rd grade 14 1st year college 04 4th grade 15 2nd year college 09 9th grade 99 Unknown 6. Severely Emotionally Disabled Youth Y 2 N 0 Severely Persistently Mentally Ill Adult Y 1 N 0 9. Age at 1st Psychiatric hospitalization 31 yrs old none 10. Prior Mental Health Service check one 32 0 No Prior Known Services 1...
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Obtain a Lebanon County application form from the official website or the local government office.
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