Get Dcfs Psychotropic Medication Request Form 2020-2026

Filling out the Dcfs Psychotropic Medication Request Form online is essential for ensuring proper medication management for children in care. This guide provides clear and detailed instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Enter the date of the request. This is usually found at the top of the form.
3. Provide the child's name and date of birth in the designated fields.
4. Select the appropriate placement for the child from the options provided: Foster Care, Residential, Hospital, or Family of Origin.
5. Fill in the CFS ID number, along with the current height and weight of the child.
6. Indicate the child's ethnicity and provide a contact telephone number.
7. Identify the prescribing physician's details, including their telephone and fax number.
8. Complete the Clinical Information section, noting any concurrent medical and psychiatric diagnoses, along with current psychotropic medications, including dosage and frequency.
9. If applicable, list any discontinued psychotropic medications and provide reasoning for the medication request.
10. Choose the type of medication request: New, Increase, 180 Day Renewal, Resume, One-Time Order, or New Ward with Current Medication.
11. For an Increase or Renewal request, indicate the current dosage in the Clinical Information section.
12. Provide the brand name, chemical name, dosage, frequency, and duration of the medication requested.
13. Detail the symptoms that warrant the requested medication and any tests or procedures necessary prior to or during treatment.
14. List any alternative treatments or medications attempted, along with reasons for their failure or rejection.
15. Confirm whether potential side effects were discussed with the child, and whether the child, if 12 years of age or older, objects to the medication.
16. Once all sections are completed, save your changes. You may choose to download, print, or share the form as needed.

Complete your Dcfs Psychotropic Medication Request Form online today to ensure effective medication management.