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PRINTED: 02/28/2022 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:SERENITY THERAPEUTIC DAY SUPPORT
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Start by gathering all necessary personal and medical information required to fill out the form.
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Fill out the client's basic information such as name, age, address, and contact details.
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Serenity Formrapeutic Day Support is a program designed to provide therapeutic care and support to individuals in need.
Individuals or organizations providing therapeutic day support services are required to file Serenity Formrapeutic Day Support.
To fill out Serenity Formrapeutic Day Support, one must provide detailed information about the therapeutic services provided and the individuals receiving the support.
The purpose of Serenity Formrapeutic Day Support is to ensure that individuals in need receive quality therapeutic care and support.
Information such as types of therapeutic services provided, number of individuals served, and outcomes of the support must be reported on Serenity Formrapeutic Day Support.
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