Get Macsis Residency Verification Form - Comhc

The Macsis Residency Verification Form - Comhc is essential for clarifying the county responsible for adjudicating claims for behavioral health services for clients. This guide provides a clear and supportive approach to help users fill out this form accurately online.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. First, identify if the client is an adult or a minor. If the client is an adult, check the box next to 'Yes' and proceed to fill out the required adult information, including the client's name, street address, city, state, zip code, signature, and date.
3. If the client is a minor, select 'Yes' and indicate whether the child is in the legal custody of a parent, CSB, DYS, court, or another specified entity. Then fill in the client’s name, legal custodian’s name, phone number of the legal custodian, and the county of the legal custodian.
4. If the parent’s address differs from the client's physical address on the enrollment form, provide the parent's address in the designated field.
5. Lastly, ensure that both the client (if an adult) and the legal custodian (if a minor) sign and date the form to confirm the provided information.
6. Once all fields are completed, save the changes, and choose to download, print, or share the form as necessary.

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