Get Initial Interview - Nc Department Of Health And Human Services - Ncdhhs

Filling out the Initial Interview form for the North Carolina Department of Health and Human Services can seem overwhelming. This guide provides clear, step-by-step instructions to help you navigate the online form with ease and confidence.

Follow the steps to accurately complete your Initial Interview form.

1. Press the ‘Get Form’ button to access the Initial Interview form. This will allow you to open it in your online editing tool.
2. Begin by entering the QP (Qualified Professional) first initial and last name at the designated field. Make sure this is accurate as it identifies the person conducting the interview.
3. Provide the consumer information, starting with the LME-MCO assigned consumer record number. If you have a provider internal consumer record number, include it too; however, this is optional.
4. Certify that you are the QP who conducted the interview by signing and dating the form in the specified areas.
5. Next, have the consumer sign and date the form as well, noting their signature placement in the consumer's file.
6. Indicate whether the consumer is also a TASC client by selecting 'Yes' or 'No'.
7. For consumers receiving or expected to receive treatment, provide details such as the current dosage. If not applicable, proceed to the next question.
8. Self-identify the consumer's ethnicity by responding to whether they are of Hispanic, Latino, or Spanish origin.
9. For demographic information, fill in the required fields such as the first three letters of the last name, first letter of the first name, date of birth, and gender.
10. Mark the appropriate age or disability categories that apply to the individual.
11. Select all services the consumer is receiving, referring to Attachment I for a detailed list if necessary.
12. Indicate the DSM-IV TR diagnostic classifications for the individual by selecting the applicable codes from Attachment II.
13. Address any additional questions related to the consumer's personal and health history, ensuring comprehensive and accurate responses.
14. Once all sections are completed, review the entire form for any errors or missing information.
15. After ensuring everything is accurate, save your changes and decide to download, print, or share the completed form as needed.

Complete your documents online today for a streamlined experience.