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NY Monroe Oasas Residential Services Application 2009-2025 free printable template

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APPLICATION FOR MONROE COUNTY OASAS RESIDENTIAL SERVICES UPDATED 09/22/12 Last Name First Name Maiden Name Name on birth certificate Gender Male Female Middle Initial NYSID Transgender for persons active in NYDCJS Have you ever been in the military Yes No Your Phone Date of birth SSN May We Leave a Message Current address City Zip Code 1. Do you inject non-prescribed drugs using a needle/syringe 3. For women Are you pregnant at this time Other describe CURRENT SERVICE PROVIDER INFORMATION...
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How to fill out NY Monroe Oasas Residential Services Application

01
Obtain the NY Monroe Oasas Residential Services Application form from the official website or designated office.
02
Fill out personal information such as name, address, and contact details in the designated sections.
03
Provide information regarding current living situation, including details about household members.
04
Detail the specific residential services being requested in the application.
05
Attach any required documentation, such as proof of income or identification, as specified in the application instructions.
06
Review the completed application for accuracy and completeness before submission.
07
Submit the application in person or through the designated mailing address, ensuring it is sent before any deadlines.

Who needs NY Monroe Oasas Residential Services Application?

01
Individuals seeking residential support services for mental health or substance abuse issues in New York.
02
Families advocating for loved ones who require residential treatment options.
03
Caregivers looking for structured living environments for those in need of support.
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The NY Monroe Oasas Residential Services Application is a form used to apply for residential services provided by the New York State Office of Addiction Services and Supports (OASAS).
Individuals seeking residential treatment services for substance use disorders in New York State are required to file the NY Monroe Oasas Residential Services Application.
To fill out the NY Monroe Oasas Residential Services Application, applicants should provide personal information, details about their substance use history, medical and mental health history, and any other relevant information as guided by the application instructions.
The purpose of the NY Monroe Oasas Residential Services Application is to assess the applicant's eligibility for residential treatment services and to gather necessary information for program placement.
The application requires reporting of personal identification details, substance use history, mental health background, medical history, and current living situation, among other pertinent information.
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