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Fall 2009Dear Mental/Behavioral Health Provider:The MS Chapter of the American Academy of Pediatrics is a membership organization for pediatricians across the state of Mississippi, currently representing
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How to fill out dear mentalbehavioral health provider

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To fill out a dear mental/behavioral health provider, follow these steps:
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Start by providing your contact information, including your name, address, phone number, and email address.
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Indicate the date and time of the appointment or the date when you are writing the letter.
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Address the letter to the mental/behavioral health provider by including their name, title, and the name of their organization.
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Begin the letter by stating your purpose. Clearly explain why you are writing the letter and what you hope to achieve.
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Provide any relevant background information that may help the provider understand your situation or condition better.
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Clearly outline the issues or concerns you would like to discuss during your appointment or therapy session.
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Express any specific goals or expectations you may have for the treatment or therapy.
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If applicable, mention any specific medications or treatments you are currently undergoing or have undergone in the past.
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Convey any preferences you have regarding the therapy or treatment approach.
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Close the letter by thanking the provider for their time and expressing your willingness to provide any additional information if necessary.
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Sign the letter and include your printed name and contact information again at the end.
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Keep a copy of the letter for your records.

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This can include individuals struggling with mental health disorders such as depression, anxiety, bipolar disorder, schizophrenia, or post-traumatic stress disorder (PTSD).
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A mental/behavioral health provider who offers services related to mental health and behavioral health.
Mental/behavioral health providers who provide services to patients are required to file.
Complete the form with accurate information about the services provided, patient details, and billing information.
The purpose is to report the services provided by mental/behavioral health providers for billing and record-keeping.
Information such as patient's name, date of service, services provided, diagnosis, and billing codes must be reported.
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