Get Hcbs Critical Incident Report Form - New Dhh Louisiana

This guide provides a comprehensive overview of how to effectively complete the HCBS Critical Incident Report Form for the Department of Health and Hospitals in Louisiana. Following these steps will help ensure that all necessary information is accurately documented.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to retrieve the form and access it in your preferred editing environment.
2. Begin with the participant identifying information. Enter the participant's first, middle, and last names, along with their address, city, state, telephone number, region, date of birth, social security number, parish, and gender. Ensure that this information is accurate as it is essential for identification.
3. Next, fill in the details regarding the family or legal guardian, including their name and contact information. Choose the appropriate service type from the available options.
4. Indicate the participant's marital status and race. Select the options provided, ensuring you are following people-first language and respectful terminology.
5. Document the living situation and legal status of the participant. This section is critical as it categorizes the support required and the participant’s living conditions.
6. Identify the incident categories that apply to the situation by checking the applicable boxes. Remember that protective services allegations must be verbally reported in addition to documented.
7. Complete the event information section by providing the date and time of the incident and when it was discovered. Indicate the location of the incident and any notifications made to the appropriate authorities.
8. Provide additional details about the incident in the Critical Incident Description section, answering the who, what, when, where, and how. This narrative should be thorough and include any relevant names and contact information for those involved.
9. After completing the form, verify all entries for accuracy, save your changes, and prepare to download, print, or share the form as necessary.

Start filling out your HCBS Critical Incident Report Form online today for efficient documentation.