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Minnesota Department of Human ServicesDHS7666ENG1218MINNESOTA HEALTH CARE PROGRAMS (MCP)Psychiatric Residential Treatment Facility (PROF)
Individual Plan of Care and Authorization
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How to fill out dhs-7666-eng psychiatric residential treatment
How to fill out dhs-7666-eng psychiatric residential treatment
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To fill out the DHS-7666-ENG Psychiatric Residential Treatment form, follow these steps:
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Begin by entering the required personal information of the individual receiving treatment, such as their name, date of birth, and social security number.
03
Provide details regarding the facility where the psychiatric residential treatment will occur, including its name, address, and contact information.
04
Specify the admission date and anticipated discharge date for the individual.
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Describe the primary reason or diagnosis for seeking psychiatric residential treatment.
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Indicate whether any medical, psychiatric, or psychological evaluations have been conducted prior to admission, and provide the relevant details.
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Document any known medical conditions or illnesses the individual has, as well as any medications they are currently taking.
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List any special dietary needs or restrictions the individual has.
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Provide information on any previous or current psychiatric or mental health treatments the individual has received.
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Include details about the individual's education, employment, and any legal involvement.
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Lastly, review the completed form for accuracy and ensure all required fields are properly filled out before submitting it.
Who needs dhs-7666-eng psychiatric residential treatment?
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Psychiatric Residential Treatment is needed by individuals who require intensive therapeutic intervention for mental health issues that cannot be adequately addressed in a less restrictive living environment.
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Typically, individuals who have severe emotional or behavioral disturbances, substance abuse problems, or significant psychiatric disorders may benefit from psychiatric residential treatment.
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This form is specifically designed for individuals who are seeking access to psychiatric residential treatment services in accordance with the regulations of the relevant authority.
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What is dhs-7666-eng psychiatric residential treatment?
The dhs-7666-eng psychiatric residential treatment is a form used to report information on psychiatric residential treatment facilities.
Who is required to file dhs-7666-eng psychiatric residential treatment?
Psychiatric residential treatment facilities are required to file dhs-7666-eng forms.
How to fill out dhs-7666-eng psychiatric residential treatment?
The dhs-7666-eng form must be completed with accurate information on psychiatric residential treatment services provided.
What is the purpose of dhs-7666-eng psychiatric residential treatment?
The purpose of dhs-7666-eng form is to track and report data on psychiatric residential treatment facilities.
What information must be reported on dhs-7666-eng psychiatric residential treatment?
Information such as facility details, services provided, patient demographics, and outcomes must be reported on dhs-7666-eng forms.
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