Get Consumer Reporting Form (crf) Admissions - Delaware Health ... - Dhss Delaware 2020-2025

Filling out the Consumer Reporting Form (CRF) Admissions for Delaware Health is an essential step in the admissions process. This guide provides clear, step-by-step instructions to ensure that users can complete the form accurately and confidently, whether they have prior experience or are new to this process.

Follow the steps to fill out the Consumer Reporting Form accurately.

1. Press the ‘Get Form’ button to access the Consumer Reporting Form and open it for editing.
2. Begin by selecting the modality of treatment by checking one box that applies: Mental Health (MH), Alcohol/Drug (AD), Co-occurring (DU), or Gambling (GA).
3. Fill out the treatment unit name and treatment unit ID number, then enter the last name, first name, and middle initial of the consumer.
4. Provide the necessary contact information including street, city, state, county, home telephone number (optional), and zip code.
5. Enter the consumer's birth date in the designated format and their social security number in the appropriate fields.
6. Indicate the consumer's gender by selecting the appropriate box for either male or female.
7. Check the racial identification by selecting one box that corresponds to the consumer’s identity.
8. Document the highest grade completed in the education section, and choose the appropriate residential arrangement.
9. Complete the current legal involvement section by selecting any that apply.
10. Fill out the primary employment details based on the consumer’s situation during the past 30 days.
11. Document the consumer's gross income per year in the provided field.
12. If applicable, indicate any history of trauma by checking the relevant boxes.
13. In the substance abuse section, provide information about substance use history, including types and frequency.
14. Complete the admission type section, which should be filled out after admission.
15. Lastly, ensure that all sections are accurately filled. Save changes, and utilize options to download, print, or share the completed form.

Start filling out the Consumer Reporting Form online today to ensure timely processing.