Get Dphhs Sltc 145

Filling out the Dphhs Sltc 145 form online can be straightforward and manageable, even for users with little legal experience. This guide will provide you with clear, step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the Dphhs Sltc 145 form online.

1. Press the ‘Get Form’ button to access the form, which will open it for you to begin the editing process.
2. Begin with filling out the applicant's personal information. This includes the applicant's name, Social Security number, and date of birth in the designated fields.
3. In the diagnosis section, provide the primary diagnosis, details of any secondary diagnoses, and physician information as requested.
4. Proceed to section A where you need to answer questions regarding mental health. Indicate if the individual has a serious mental illness, any indications of mental illness, and whether they are on any antipsychotic or antidepressant medications.
5. Next, in section B, address mental retardation or related conditions by indicating if the individual has such diagnoses and answering related questions.
6. Complete the information source section with your name, agency, and contact details to ensure proper communication.
7. Double-check all entries for accuracy, and if any corrections are needed, revise them accordingly.
8. Once all sections are completed and verified, save the changes to the form. You can choose to download, print, or share the completed document as needed.

Fill out your Dphhs Sltc 145 form online now to ensure a smooth process for nursing facility services.