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State of Mississippi Form MBR1 (2009)South Mississippi State Hospital38800BUDGET REQUEST FOR FISCAL YEAR ENDING JUNE 30, 2011 823 Highway 589, Paris, MS. 39475AGENCYWynona C. Winfield, DirectorADDRESSCHIEF
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How to fill out mississippi state hospital authorization
How to fill out mississippi state hospital authorization
01
Obtain the proper authorization form from the Mississippi State Hospital.
02
Fill out your personal information including name, address, contact information, and date of birth.
03
Provide information about your medical history and current condition.
04
Include details about your primary care physician or referring doctor.
05
Sign and date the form to confirm your consent for treatment.
Who needs mississippi state hospital authorization?
01
Individuals who require treatment or services at the Mississippi State Hospital.
02
Patients who have been referred by their primary care physician or healthcare provider.
03
Anyone seeking mental health services or treatment in a hospital setting.
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What is mississippi state hospital authorization?
Mississippi State Hospital Authorization is a document required for individuals seeking treatment or services at state-operated mental health facilities in Mississippi.
Who is required to file mississippi state hospital authorization?
Individuals seeking admission to a Mississippi state hospital, or their legal guardians, are required to file the Mississippi State Hospital Authorization.
How to fill out mississippi state hospital authorization?
To fill out the Mississippi State Hospital Authorization, follow the provided guidelines on the form, including personal information, treatment details, and signature of authorized representatives.
What is the purpose of mississippi state hospital authorization?
The purpose of the Mississippi State Hospital Authorization is to ensure that individuals receive necessary mental health services while complying with state regulations and guidelines.
What information must be reported on mississippi state hospital authorization?
The Mississippi State Hospital Authorization must include personal identification details, medical history, consent for treatment, and information about the individual's mental health condition.
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