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DocuSign Envelope ID: B422683F5C984EC29C2138061061C66461165 Y3SUBAWARD BETWEEN THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES AND REGION V SYSTEMS This federal funds grant agreement, including

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How to fill out fy22 region 5 mh-sud

01

Step 1: Obtain the FY22 Region 5 MH-SUD form.

02

Step 2: Read the instructions carefully to understand the requirements.

03

Step 3: Fill out the personal information section, including your name, contact details, and any other required details.

04

Step 4: Provide information about your mental health and substance use disorder in the specified sections.

05

Step 5: Include any relevant medical history or treatment you have received.

06

Step 6: Complete the financial information section, providing details about your income, insurance, and any assistance you receive.

07

Step 7: Review the completed form for accuracy and completeness.

08

Step 8: Submit the filled-out FY22 Region 5 MH-SUD form to the designated authority or agency.

Who needs fy22 region 5 mh-sud?

01

Individuals residing within Region 5 who require mental health and substance use disorder services in the fiscal year 2022 (FY22) need to fill out the FY22 Region 5 MH-SUD form. This includes individuals dealing with mental health issues, substance abuse problems, or both, who seek assistance, treatment, or support within the Region 5 area.

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What is fy22 region 5 mh-sud?

FY22 Region 5 MH-SUD refers to the mental health and substance use disorder data reported for Region 5 in fiscal year 2022.

Who is required to file fy22 region 5 mh-sud?

Providers and organizations in Region 5 that offer mental health and substance use disorder services are required to file FY22 Region 5 MH-SUD.

How to fill out fy22 region 5 mh-sud?

To fill out FY22 Region 5 MH-SUD, providers need to report specific data related to mental health and substance use disorder services provided in Region 5 during the fiscal year 2022.

What is the purpose of fy22 region 5 mh-sud?

The purpose of FY22 Region 5 MH-SUD is to gather data on mental health and substance use disorder services in Region 5 to assess the availability and effectiveness of such services.

What information must be reported on fy22 region 5 mh-sud?

Providers must report data on the types of services offered, number of patients served, outcomes achieved, and any challenges or successes encountered in providing mental health and substance use disorder services in Region 5.

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