Get Locus Recording Form

The LOCUS Recording Form is a crucial document used to assess the needs of recipients of mental health services. Completing this form accurately ensures that individuals receive the appropriate level of care and support tailored to their needs.

Follow the steps to successfully complete the LOCUS Recording Form online.

1. Press the ‘Get Form’ button to obtain the LOCUS Recording Form and open it for editing.
2. Fill in the 'Date of Assessment' section with the date the evaluation was conducted.
3. Enter the 'Recipient Date of Birth' in the format Month/Day/Year (MM/DD/YYYY).
4. Indicate the 'Recipient Gender' by selecting either 'Male' or 'Female'.
5. Provide the 'Recipient PMI or Social Security Number', using the PMI number if available.
6. Complete the 'Diagnosis' by writing the full name of the primary diagnosis or the corresponding ICD code.
7. In the 'Risk of Harm' section, select the appropriate rating from 1 to 5 and document any relevant criteria letter(s) used.
8. For the 'Functional Status', choose the level that accurately describes the recipient's functional capacity.
9. Document the 'Co-Morbidity' by selecting the relevant status of additional health concerns.
10. Assess the 'Recovery Environment' in both IV-A and IV-B, and select the appropriate levels of stress and support.
11. In the 'Engagement' section, evaluate and select the level of the recipient's engagement.
12. Calculate the 'Composite Score' by summing the scores from each dimension.
13. Provide the 'Provider Name', 'NPI', and 'Service Type' to identify the professional completing the form.
14. Write the 'Level of Care Recommendation' based on the score received and the decision tree.
15. Indicate the 'Actual Level of Care Provided', which may differ from the recommendation, if applicable.
16. List the 'Service(s) Recipient is Receiving or Referred to', ensuring you capture all relevant programs.
17. If applicable, complete the 'Reason for Variance' to provide clinical justification for any differences in care level.
18. Sign and date the form in the designated areas to verify accuracy and completion by the provider.
19. Finally, save any changes made to the document. Options include downloading, printing, or sharing the completed form as needed.

Complete the LOCUS Recording Form online today to ensure accurate assessments and appropriate care for recipients.