Get the free Form F-00258 Functional Eligibility Screen for Mental Health ... - dhs wisconsin
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DEPARTMENT OF HEALTH SERVICES Division of Care and Treatment Services F00258 (08/2016)STATE OF WISCONSINFUNCTIONAL ELIGIBILITY SCREEN FOR MENTAL HEALTH AND MENTAL HEALTH & SODA (OCCURRING) SERVICES
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How to fill out form f-00258 functional eligibility
How to fill out form f-00258 functional eligibility
01
Obtain form f-00258 functional eligibility from the appropriate agency or organization
02
Read the instructions on the form carefully before filling it out
03
Provide all necessary information and supporting documentation as requested on the form
04
Complete all sections of the form accurately and legibly
05
Review the completed form for any errors or missing information before submitting it
Who needs form f-00258 functional eligibility?
01
Individuals seeking eligibility for functional services such as disability benefits or support services
02
Caregivers or guardians of individuals who require functional services
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What is form f-00258 functional eligibility?
Form f-00258 functional eligibility is a document used to determine if an individual meets the functional eligibility requirements for a specific program or service.
Who is required to file form f-00258 functional eligibility?
Individuals who are applying for or receiving a program or service that requires functional eligibility assessment are required to file form f-00258.
How to fill out form f-00258 functional eligibility?
Form f-00258 functional eligibility can be filled out by providing accurate and detailed information about the individual's functional abilities and limitations.
What is the purpose of form f-00258 functional eligibility?
The purpose of form f-00258 functional eligibility is to ensure that individuals who need specific programs or services meet the necessary functional eligibility requirements.
What information must be reported on form f-00258 functional eligibility?
Information such as the individual's medical history, functional limitations, and any other relevant details must be reported on form f-00258 functional eligibility.
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