Get Documentation Of Direct Services Providers - Forms In

This guide provides a clear and systematic approach to completing the DOCUMENTATION OF DIRECT SERVICES PROVIDERS - Forms In online. By following the steps outlined here, users can efficiently provide the necessary information for Addiction Treatment Services Provider Outpatient Certification.

Follow the steps to successfully complete the form online:

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. In the first section, enter the legal name of the applicant entity or agency applying for certification.
3. List the names of all individuals providing direct services in the specified field. A direct services provider is anyone who offers counseling, psychological, medical, or social services on behalf of the provider.
4. For each individual listed, indicate the type of service they provide by selecting from the designated keys: CO for counseling, PSY for psychological, Med for medical, and Soc for social service.
5. Next, indicate the working relationship of each direct services provider using the keys: E for employee, V for volunteer, and C for contracted staff member.
6. Ensure that at least fifty percent of the direct services providers hold relevant licenses or credentials as specified in the form.
7. Verify that at least one direct services provider is credentialed in addictions counseling by an approved credentialing body listed.
8. Complete any remaining fields for each provider, including current license or credential information and its expiration date.
9. Review all entries for accuracy and completeness before proceeding.
10. Once all information is entered correctly, save any changes, and choose to download, print, or share the form as needed.

Start filling out your documents online today to ensure compliance and facilitate the certification process.