Get Choice Program - Progress Summary

The Choice Program - Progress Summary is an essential document for veterans seeking to report progress in their treatment. This guide will provide clear, step-by-step instructions on how to complete the form accurately and efficiently online.

Follow the steps to fill out the Choice Program - Progress Summary.

1. Press the ‘Get Form’ button to acquire the form and open it in your selected editor.
2. Begin by filling in the veteran's name at the top of the form. Follow this by entering the Department of Defense ID or benefits number, or the sponsor's Social Security number. Ensure these details are accurate to avoid processing delays.
3. Next, provide the date the form is completed and the VA authorization number associated with the veteran's case.
4. Enter the veteran's complete address including street, city, state, and zip code. Make sure to include a contact telephone number.
5. Select the veteran's service branch from the listed options such as Army, Navy, USAF, USMC, USCG, or Other. In case of other insurance, indicate 'yes' or 'no' and specify if applicable.
6. Complete the section for patient date of birth and ensure to fill in the relevant state and zip code. Include any additional applicable insurance information.
7. Provide the provider's name and license type, followed by their telephone number, address, and fax number. It's important to ensure that you include the correct provider TIN and NPI.
8. Document the DSM-V diagnosis and any co-occurring medical conditions relevant to treatment, listing these in the provided fields.
9. Indicate whether the patient has had a psychiatric hospitalization in the past 90 days by selecting 'yes' or 'no.' Be sure to record the dates of service, including CPT codes and descriptions for each service provided.
10. Detail the treatment progress in the designated space, offering a brief statement of the client’s engagement and participation in their treatment journey.
11. Finally, if there are any treatment plan changes, note them accordingly in the provided section. Ensure the provider's signature, credentials, and date are included at the end of the form.
12. Once you have filled out the form, save your changes and choose to download, print, or share it as necessary.

Complete your forms online to ensure timely processing and effective management of your healthcare.