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Health Financial SystemsMCRIF32FOR HARSH BEHAVIORAL CENTERING LIEU OF FORM CMS255296(04/2005) PREPARED 5/30/2011 23:20 FORM APPROVED OMB NO. 09380050THIS REPORT IS REQUIRED BY LAW (42 USC 1395g; 42
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Contact Usharsha Behavioral Center is a mental health facility that provides counseling and therapy services.
All patients and clients who receive services from Usharsha Behavioral Center are required to fill out contact information forms.
Patients can fill out the contact information forms provided by Usharsha Behavioral Center either in person or online.
The purpose of the contact information forms is to keep accurate records of patients and clients receiving services at Usharsha Behavioral Center.
Contact information forms typically require patients to provide their full name, contact details, emergency contacts, and insurance information.
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