We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Social Forms
  • South Carolina Social Forms
  • Sc Select Health Substance Abuse Discharge Note

Get Sc Select Health Substance Abuse Discharge Note

Substance Abuse Discharge Note (Medical Detoxification and SUD Rehabilitation including DAODAS Facilities) Please fax to 8887965521 24 hours prior to discharge. Todays date: Contact information Member.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the SC Select Health Substance Abuse Discharge Note online

Filling out the SC Select Health Substance Abuse Discharge Note online is an essential process for ensuring a smooth transition for individuals receiving substance abuse treatment. This guide offers detailed instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete your discharge note.

  1. Use the ‘Get Form’ button to access the discharge note and open it in an online editor.
  2. Enter today's date at the start of the form to indicate when the discharge note is being completed.
  3. Provide the contact information for the member, including their name, member ID number, date of birth, phone number, and the referral source.
  4. Fill in the details of the facility, including its name and NPI or provider number.
  5. Document the date of admission and the discharge information, indicating if the member was discharged to home, shelter, etc.
  6. Specify the date of discharge and include the discharge address and phone number.
  7. If the member is a minor or dependent adult, input the name and contact information of the parent or guardian.
  8. Detail the ICD-10 discharge diagnoses related to psychiatric, chemical dependency, and medical issues.
  9. Indicate if the discharge was against medical advice (AMA) by selecting 'Yes' or 'No'.
  10. State whether discharge information was sent to the primary care provider (PCP) or psychiatrist.
  11. Confirm if the discharge plan was discussed with the member.
  12. For minors or dependent adults, indicate if informed consent for psychotherapeutic medication was completed and given to the parent or guardian.
  13. Complete the ASAM rating for each dimension at the time of discharge, providing explanations as needed.
  14. State whether the member was transitioned to a lower level of care and provide specifics if applicable.
  15. List all discharge medications, including dosage, frequency, and condition for which they are prescribed, and indicate if they are on the formulary.
  16. Assess the member's stability at discharge, noting any risks for suicide, homicide, or psychosis.
  17. Record the details for aftercare appointments, including provider name, contact number, date, and time, ensuring one is scheduled within seven calendar days.
  18. Include any other providers involved in the aftercare plan, listing them with contact information.
  19. Sign the form at the bottom, providing the name and phone number of the person submitting the form along with the date of submission.
  20. Once all information is accurately filled, save changes and choose to download, print, or share the completed discharge note.

Start filling out the SC Select Health Substance Abuse Discharge Note online to ensure a successful discharge process.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

SelectHealth Plan
as Medicare's prescription drug coverage, your monthly Medicare Part D premium will go...
Learn more
the value of hospital discharge databases - HCUP...
to promote the creative use of health care data for research, policy, and market ... work...
Learn more
2013 Adult Correctional Systems Survey...
Alabama and Louisiana's drug offenders include state inmates in state prisons and local...
Learn more

Related links form

2012-OLC-Annual Mtg-FlyerFinal.pub - Ohio Department Of Agriculture - Agri Ohio Final Order - Umpqua Title & Escrow Services - 12/21/99. Umpqua Title & Escrow Services Inc ) 0B107211-F JANUARY 3, 2011 General Services Division Office Of Procurement Services 4200 Surface Credit Card Application - State Of Oklahoma

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Menu alignment By default, a dropdown menu is automatically positioned 100% from the top and along the left side of its parent. Add .dropdown-menu-right to a .dropdown-menu to right align the dropdown menu. Heads up! Dropdowns are positioned thanks to Popper.js (except when they are contained in a navbar).

Dropdown Explicit Positioning alignment: left: It is used to align the dropdown container left with respect to the button. right: It is used to align the dropdown container right with respect to the button. top: It is used to align the dropdown container top with respect to the button.

Edit a drop-down list with items that have been entered manually On the worksheet where you applied the drop-down list, select a cell that has the drop-down list. Go to Data > Data Validation. On the Settings tab, click in the Source box, and then change your list items as needed.

Dropdown Explicit Positioning alignment: left: It is used to align the dropdown container left with respect to the button. right: It is used to align the dropdown container right with respect to the button. top: It is used to align the dropdown container top with respect to the button.

Select the cell in the worksheet where you want the drop-down list. Go to the Data tab on the Ribbon, then select Data Validation. On the Settings tab, in the Allow box, select List. If it's OK for people to leave the cell empty, check the Ignore blank box.

To get an XPATH of an element right-click the Dropdown menu and select 'Inspect element with Firebug'. Then corresponding code would be highlighted in the firebug, right-click on it and select copy XPath. By this method we can copy the XPATH and paste it into the Selenium IDE tool's Target section.

Example Explained Use any element to open the dropdown menu, e.g. a <button>, <a> or <p> element. Use a container element (like <div>) to create the dropdown menu and add the dropdown links inside it. Wrap a <div> element around the button and the <div> to position the dropdown menu correctly with CSS.

Foundation CSS Dropdown Positioning Classes: top: It is used to position the dropdown at the top of the element. bottom: It is used to position the dropdown at the bottom of the element. left: It is used to position the dropdown at the left of the element.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get SC Select Health Substance Abuse Discharge Note
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232