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Mary Ann McDonnell, PhD, RMS, CNS, PMH NP Phone: 7818378833 Fax: 7817350457 160 Old Derby St. Suite 457, Gingham, MA 02043 Email: maryannmcdonnell yahoo.com Parent Request for Psychiatric Evaluation
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Start by gathering all the necessary documents and information. This may include identification, medical history, contact information, and any relevant paperwork.
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Begin by filling out the personal details section. This usually includes the individual's name, date of birth, address, and contact information.
03
Move on to the medical history section. Provide details about any existing medical conditions, allergies, medications, and previous surgeries or treatments.
04
If applicable, fill out the section regarding mental health history. Include information about any previous diagnoses, therapies, or medications related to mental health.
05
Next, provide information about any current medications the individual is taking. Include the name, dosage, and frequency of each medication.
06
Fill out the section on allergies, if relevant. Include details about any known allergies, including food, medication, or environmental triggers.
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If the individual is currently under any special care or services, provide information about the caregiver or service provider.
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Finally, review the entire form for accuracy and completion. Make sure all mandatory fields are filled out and all necessary attachments are included.
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Sign and date the form as required, and submit it to the appropriate authority or organization.

Who needs new adult intake 6-18?

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The new adult intake form, specifically for ages 6-18, is typically required for individuals who are transitioning from pediatric care to adult care.
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This form helps healthcare providers gather essential information about the individual's medical history, allergies, medications, and any existing conditions.
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It is beneficial for individuals who are starting to take more responsibility for their own healthcare decisions and need to provide information to medical professionals.
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New adult intake 6-18 refers to a process or form required for individuals aged 6 to 18 to provide necessary information for new adult intake services or programs.
Typically, individuals or guardians of minors aged 6 to 18 are required to file the new adult intake 6-18 form.
To fill out the new adult intake 6-18 form, individuals should follow the instructions provided on the form, ensuring all necessary personal and demographic information is accurately completed.
The purpose of new adult intake 6-18 is to gather relevant information about minors for evaluation and access to appropriate services.
Information that must be reported typically includes personal details such as name, age, address, medical history, and any other relevant data requested by the form.
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