NC DMH 5-72-19 2019-2026 free printable template
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1 to perform the first examination for involuntary commitment described in G.S. 122C263 c or G.S. 122C-283 c. G.S. 122C-3 16a does not constitute a medical evaluation and should be completed at the same location as the first examination or by utilizing telemedicine equipment and procedures N.C. STATE OF NORTH CAROLINA Department of Health and Human Services Division of Mental Health Developmental Disabilities and Substance Abuse Services County FIRST EXAMINATION FOR INVOLUNTARY COMMITMENT...
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How to fill out NC DMH 5-72-19
How to fill out NC DMH 5-72-19
01
Begin by downloading the NC DMH 5-72-19 form from the official website.
02
Fill in the personal information section, including your name, address, and contact details.
03
Provide information about the individual's mental health history as required.
04
Ensure you check the appropriate boxes that pertain to the individual's conditions or circumstances.
05
Include any relevant medical or therapeutic interventions that have been received.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form at the designated areas.
Who needs NC DMH 5-72-19?
01
Individuals seeking mental health services in North Carolina.
02
Caregivers or family members of individuals with mental health needs.
03
Mental health professionals who require documentation for services.
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What is NC DMH 5-72-19?
NC DMH 5-72-19 is a form used by the North Carolina Department of Mental Health for reporting specific data related to mental health services.
Who is required to file NC DMH 5-72-19?
Organizations or individuals that provide mental health services in North Carolina and are subject to reporting requirements by the state must file NC DMH 5-72-19.
How to fill out NC DMH 5-72-19?
To fill out NC DMH 5-72-19, you need to provide accurate data as outlined in the form instructions, including patient details, service provided, and any relevant assessments.
What is the purpose of NC DMH 5-72-19?
The purpose of NC DMH 5-72-19 is to collect data to improve mental health services and ensure compliance with state regulations.
What information must be reported on NC DMH 5-72-19?
Information that must be reported includes client demographics, types of services rendered, dates of service, and outcomes of the services provided.
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