Get Grhhn 2020-2025

This guide provides clear instructions on how to complete the Grhhn form online for care management referrals. Whether you are a provider, community organization, or an individual seeking assistance, following these steps will ensure a smooth submission process.

Follow the steps to accurately complete the Grhhn form for care management referrals.

1. Press the ‘Get Form’ button to access the Grhhn form and open it in the online editor.
2. Fill in the identifying information section, which includes the name, date of birth, address, and other necessary details such as Medicaid CIN# and contact information.
3. Complete the eligibility category section by checking all categories that apply, including serious mental illness or chronic conditions.
4. List current medical or behavioral health treatment providers, if known, to aid in care management.
5. Indicate care management needs by checking categories such as probable risk for adverse events or lack of social support, providing an explanation where necessary.
6. Address any risk and safety concerns by checking applicable items, such as suicidal ideation or unsafe living conditions.
7. Provide any additional narrative that may assist in the assignment to a care management agency, including strengths and interests.
8. Indicate the preferred or recommended care management agency, if any.
9. Fill out the contact information for the person completing the referral, ensuring all details are accurate.
10. Sign the consent form to permit the use and disclosure of confidential information, specifying details and dates needed.
11. Review all sections for completeness and accuracy before submitting.
12. Lastly, save your changes, and you can then download, print, or securely share the completed form.

Complete your care management referral documents online today!