Get Appendix 2-illinois Puns Form - Illinois Department Of Human ... - Dhs State Il

The Appendix 2-Illinois PUNS Form is essential for individuals needing services through the Illinois Department of Human Services. This guide provides professional, clear, and supportive instructions on how to fill out the form online, ensuring that all users can navigate it with confidence.

Follow the steps to complete the form accurately and efficiently.

1. Click 'Get Form' button to obtain the form and open it in the online editor.
2. Indicate the date the form is completed and signed in the designated field. Ensure the date format is correct (MM/DD/YYYY).
3. Provide the full name of the individual in the respective fields for first name, middle initial, and last name.
4. Fill in the Social Security Number in the provided format, separating the number sections appropriately.
5. Select the reason for completing the PUNS or updating it by checking only one option from the list provided.
6. Record the name of the service coordinator, ensuring legibility, and include their signature and agency details.
7. Complete the individual and guardian information sections, providing signatures where required. Ensure accurate phone numbers are listed.
8. Enter the primary caregiver's information, including their date of birth and address, if applicable.
9. If there is a secondary caregiver, list their date of birth as requested.
10. Complete the client case registration information, including agency details and staff information. Make sure all relevant fields are filled accurately.
11. Indicate demographic information, including race, sex, and primary language as required.
12. Fill out the guardian information and ensure the details match legal documents where applicable.
13. Complete the clinical information and diagnosis sections, providing accurate details regarding the individual’s health as required.
14. Specify the supports needed and existing supports by checking the relevant boxes. Provide details where necessary.
15. Review all sections for accuracy and completeness before finalizing.
16. Once all fields are completed, save changes, and utilize the options to download, print, or share the form as necessary.

Take the first step towards accessing vital services—complete your Appendix 2-Illinois PUNS Form online today.