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Indiana Division of Mental Health and Addiction All Hazards Committee District Mental Health Response Team Medical Information Form General Information Name Nickname Address State Date of Birth Sex:
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Gather all relevant information that you will need to fill out the Indiana Division of Mental form.
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The Indiana Division of Mental Health and Addiction is a state agency responsible for overseeing mental health and addiction services in Indiana.
Certain healthcare providers, facilities, and organizations in Indiana are required to file reports with the Indiana Division of Mental Health and Addiction.
The Indiana Division of Mental Health and Addiction provides specific forms and instructions for filing reports, which can be found on their official website.
The purpose of the Indiana Division of Mental Health and Addiction is to monitor and improve mental health and addiction services in the state.
Information such as patient demographics, diagnoses, treatments, and outcomes may need to be reported on the Indiana Division of Mental Health and Addiction forms.
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