Get Pasaar 4345

Filling out the Pasaar 4345 form is an essential step for individuals seeking admission to nursing facilities. This guide provides clear instructions on how to complete each section of the form accurately and efficiently, ensuring that all necessary information is provided.

Follow the steps to successfully complete the Pasaar 4345 online.

1. Press the ‘Get Form’ button to obtain the Pasaar 4345 form and open it in your preferred online editor.
2. Begin by entering the applicant's last name, first name, middle initial, date of birth, and social security number in the designated fields.
3. Indicate the sex of the applicant by selecting either 'M' for male or 'F' for female.
4. Fill in the actual or requested admission date to the nursing facility.
5. Provide the current location of the individual and complete their residential address, including city, state, and ZIP code.
6. Enter the contact person’s name, their title or relationship to the applicant, and their telephone number.
7. In section A, answer the three questions regarding exempted hospital discharge by checking 'Yes' or 'No' for each question.
8. If all three questions in section A are answered 'Yes', sign and date the form at the bottom to indicate no further screening is required.
9. If any question in section A is 'No', continue to sections B and C, answering each question related to intellectual disability and serious mental illness.
10. After completing relevant sections, certify that the information provided is correct, sign the form, and include your title and date.
11. For completion, save the form, and consider downloading, printing, or sharing it as necessary.

Complete your Pasaar 4345 form online today for a smooth admission process.