Get Form 08oa001e (tefra-1) - Okdhs

Filling out the Form 08OA001E (TEFRA-1) is a crucial step in accessing necessary home care services for children with special needs. This guide provides a comprehensive, step-by-step approach to help you complete the form accurately and efficiently online.

Follow the steps to complete your form with ease.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering the child information. Fill in the child's last name, first name, date of birth, social security number, and current residence. Make sure to include the street address, city, state, and zip code.
3. Next, provide the parent, guardian, or designated representative contact information. Include their last name, first name, street address, city, state, zip code, relationship to the child, and phone number.
4. In the personal history section, list the primary caregiver's name and relationship to the child. Indicate whether the primary caregiver works and provide their work schedule for each day of the week.
5. Repeat the previous step for the secondary caregiver, if applicable, including their work schedule.
6. Indicate whether the child is currently in school and provide the school schedule if applicable. Include any special plans like an Individual Education Plan (IEP) or Individual Family Service Plan (IFSP), submitting current documentation as needed.
7. For medications, fill in the necessary details including the name, dose, route, and frequency. Attach additional sheets if needed.
8. Move on to home services by listing each service provided and detailing the nursing care, physical therapy, occupational therapy, speech therapy, and any other relevant services along with their costs and schedules.
9. Complete the home care needs section, detailing any necessary respiratory care, catheter care, nutritional care, and the associated monthly costs.
10. Describe any equipment rentals, listing providers and monthly costs for items like wheelchairs, oxygen monitors, and other medical equipment.
11. If receiving personal care through OKDHS, provide the provider's work schedule.
12. Address any transportation needs by describing special transport requirements related to frequency, vehicle type, expense, and time.
13. Sign the form to affirm that the information provided is accurate.
14. Instruct a licensed physician to complete the recommendation section, identifying the child's primary and secondary diagnoses and their recommended level of care.
15. Finally, review the entire form for completeness and accuracy before saving your changes, downloading, printing, or sharing the form as needed.

Complete your documents online today to ensure timely access to necessary services.