MA Enrollment Assessment Section 35 2012 free printable template

Version 2 September 2012 Bureau of Substance Abuse Services Massachusetts Department of Public Health Page 1 of 4 Enrollment Date / mm dd yyyy Enrollment Assessment Section 35 ESM Client ID Provider ID Questions Q marked with must be completed. Boxes marked with Refer to Key at end of form First Name Middle Initial Suffix 3. Intake/Clinician Initials 1. Client Code 3. Do you own or rent a house apartment or room 3a* Are you Chronically Homeless HUD Definition in Manual Last Name Yes No If the...

How to fill out MA Enrollment Assessment Section 35

How to fill out MA Enrollment Assessment Section 35

1. Gather all necessary personal information including your name, address, and contact details.
2. Collect any relevant healthcare information such as your medical history and current medications.
3. Read through the instructions carefully to understand what is required in each section of the assessment.
4. Begin filling out Section 35 by providing truthful and accurate information as requested.
5. Make sure to check any boxes or fill in any required fields to avoid incomplete sections.
6. Review your responses for clarity and correctness before submitting the form.
7. If necessary, seek assistance from a healthcare provider or support personnel for clarification on any questions.

Who needs MA Enrollment Assessment Section 35?

1. Individuals applying for Medicaid or MA benefits.
2. Patients who are undergoing assessments for eligibility for medical assistance.
3. Healthcare providers who are required to assist patients in the enrollment process.

People Also Ask about

How do I section someone for mental health in Massachusetts?

Individuals (such as family members) can ask the court to order an emergency mental health commitment, called Section 12 (e) or a commitment for treatment of alcohol or substance use disorder, called a Section 35, by speaking to a clerk in the court.

What is Section 35 Massachusetts?

Section 35 is a Massachusetts law that allows a qualified person to request a court order requiring someone to be civilly committed and treated involuntarily for an alcohol or substance use disorder.

What is a warrant of apprehension in Massachusetts?

Warrant of apprehension — If the judge issues a warrant of apprehension, the warrant is sent to the local police. The police will try to arrest the respondent at the address you give them.

What is Section 35?

The criminal courts can send you to hospital using section 35 of the Mental Health Act. They can do this if they want more information about your mental health. The courts use section 35 when they decide you need an assessment in hospital. They can use this section at any point during your court case.

What kind of warrants are there in Massachusetts?

Massachusetts courts can issue two types of arrest warrants: default warrants and straight warrants. Default warrants are issued by a judge after the defendant has failed to appear for court. Straight warrants, on the other hand, are issued by the court at the request of police or prosecutors.

What does warrant to apprehend mean?

These warrants are issued by the Court when a defendant has failed to appear in court on the date stipulated on either the summons or the bail agreement.

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What is MA Enrollment Assessment Section 35?

MA Enrollment Assessment Section 35 is a form used to collect data on the enrollment status of individuals in a specific program, often related to state healthcare initiatives.

Who is required to file MA Enrollment Assessment Section 35?

Entities or organizations administering health programs that involve Medicaid recipients are required to file MA Enrollment Assessment Section 35.

How to fill out MA Enrollment Assessment Section 35?

To fill out MA Enrollment Assessment Section 35, provide accurate details regarding the enrolled individuals, including personal information, coverage details, and any relevant enrollment dates.

What is the purpose of MA Enrollment Assessment Section 35?

The purpose of MA Enrollment Assessment Section 35 is to monitor and assess enrollment in Medicaid programs to ensure compliance and improve healthcare services.

What information must be reported on MA Enrollment Assessment Section 35?

Information that must be reported includes participant names, identification numbers, enrollment dates, demographic details, and the type of coverage provided.