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EXHIBIT 12201 STATE OF ARIZONA INSTRUCTIONS (OVER) ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM PARR SCREENING DOCUMENT LEVEL I Am. MEMBER INFORMATION B. EXEMPTIONS (circle answer) 1) NAME: last, first
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How to fill out pasrr screening document level:

01
Begin by carefully reading the instructions provided on the pasrr screening document level form. This will give you a clear understanding of what information needs to be included and how to properly fill it out.
02
Start by providing the necessary personal information of the individual undergoing the screening, such as their full name, date of birth, and contact details. Make sure to double-check the accuracy of this information before proceeding.
03
Next, provide any relevant healthcare information in the designated sections of the form. This may include the individual's medical history, current medications, and any known disabilities or mental health conditions.
04
Ensure that all the required sections of the pasrr screening document level form are completed. This may include sections related to the individual's cognitive and functional abilities, as well as any behavioral or psychiatric symptoms.
05
If certain sections of the form do not apply to the individual undergoing the screening, clearly indicate this by marking them as "not applicable" or "N/A."
06
Once you have filled out all the necessary information, review the entire form to catch any errors or omissions. It is essential to provide accurate and complete details to ensure an effective pasrr screening process.
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Finally, sign and date the form, indicating that all the information provided is true and accurate to the best of your knowledge.

Who needs pasrr screening document level?

01
Individuals who are seeking nursing home placement or residential care services are typically required to undergo pasrr screening.
02
Individuals who have a known or suspected mental illness, intellectual or developmental disabilities, or related conditions are also subject to pasrr screening.
03
Additionally, pasrr screening may be necessary for individuals who have experienced a significant change in their mental or physical health condition and require a reassessment of their care needs.
Please note that specific pasrr screening requirements may vary from state to state, so it's important to consult the relevant regulations and guidelines for accurate information.
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Pasrr screening document level refers to the assessment process for determining the level of care needed for individuals seeking long-term care services.
Healthcare providers and facilities, as well as individuals applying for long-term care services, are required to file pasrr screening document level.
Pasrr screening document level can be filled out by healthcare professionals following the guidelines provided by the relevant authorities.
The purpose of pasrr screening document level is to ensure that individuals receive the appropriate level of care based on their needs and condition.
Pasrr screening document level must include detailed medical and personal information about the individual to determine the level of care required.
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