Get Ucla Adult Partial Hospitalization Program Form

This guide is designed to assist users in filling out the Ucla Adult Partial Hospitalization Program Form online. By following the steps outlined below, you will be able to complete the form with ease and ensure all necessary information is provided.

Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to access the Ucla Adult Partial Hospitalization Program Form and open it in the designated editing tool.
2. Begin with the personal information section. Here, you will need to provide your full name, date of birth, address, and contact details. Ensure that all spelling is accurate and information is current.
3. Complete the eligibility section. Indicate whether you live within the specified geographic area from UCLA, as this will determine your eligibility for the program.
4. Fill out the section regarding your medical history. Include any relevant psychiatric treatments, medications you are currently taking, and any previous hospitalizations. This information is critical for the clinical team to provide appropriate care.
5. Provide information regarding your support system. This includes naming your community-based therapist, if applicable, and listing any family members or partners who will be involved in your care.
6. Review all your entries for accuracy. Make sure that contact information and personal details are correctly filled out to avoid any processing delays.
7. Once you've ensured that all sections are completed, you have the option to save your changes, download a copy of the form, print it for your records, or share it with the necessary parties.

Complete your Ucla Adult Partial Hospitalization Program Form online today to take the first step towards your recovery.