Get the free 470-5717, Pre-Aftercare Referral Form

Iowa Department of Health and Human ServicesPreAftercare Referral Form \"PreAftercare Services\" means services provided to youth age 17, who are expected to qualify for the Iowa Aftercare Services

How to fill out 470-5717 pre-aftercare referral form

How to fill out 470-5717 pre-aftercare referral form

1. Obtain the 470-5717 pre-aftercare referral form from the relevant agency or website.
2. Fill out the patient's personal information at the top of the form, including name, date of birth, and contact details.
3. Provide details about the patient's medical history and any current treatments or medications.
4. Enter the specifics of the aftercare services required, including type of service and duration.
5. Sign and date the form to certify that the information provided is accurate.
6. Submit the completed form to the designated authority or agency for processing.

Who needs 470-5717 pre-aftercare referral form?

1. Patients transitioning from inpatient care to outpatient services.
2. Healthcare providers looking to refer patients for aftercare support.
3. Individuals requiring follow-up treatment or rehabilitation services.

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What is 470-5717 pre-aftercare referral form?

The 470-5717 pre-aftercare referral form is a document used to initiate the process of providing aftercare services to individuals who have completed a treatment program.

Who is required to file 470-5717 pre-aftercare referral form?

Organizations and professionals who are involved in the treatment and recovery process of clients are required to file the 470-5717 pre-aftercare referral form.

How to fill out 470-5717 pre-aftercare referral form?

To fill out the 470-5717 pre-aftercare referral form, you need to provide accurate client information, including details about their treatment history, aftercare needs, and designated service providers.

What is the purpose of 470-5717 pre-aftercare referral form?

The purpose of the 470-5717 pre-aftercare referral form is to ensure that individuals receive appropriate aftercare services post-treatment to support their recovery.

What information must be reported on 470-5717 pre-aftercare referral form?

The form requires reporting information such as the client's personal details, treatment history, recommendations for aftercare, and contact information of involved providers.