Get Mn Dhs Dhs-5204-eng 2013-2025

Filling out the MN DHS DHS-5204-ENG form is a crucial step in the Rule 25 assessment process for individuals seeking support for alcohol and drug use. This guide provides clear instructions on how to complete the form online efficiently and accurately.

Follow the steps to complete the MN DHS DHS-5204-ENG form online.

1. Use the ‘Get Form’ button to access the online version of the form and open it in your preferred PDF editor.
2. Begin with section one by entering the date of the assessment request and assessment date, along with the assessor's name and contact number.
3. Fill in your personal information by providing your full name, date of birth, age, gender, and primary language. Include current address and phone numbers.
4. In the designated area, describe the circumstances that have led to your assessment request. Provide detailed information about your situation.
5. Indicate whether you have previously undergone Rule 25 assessments and provide any pertinent details if applicable.
6. Proceed to discuss your chemical use history by providing details on substance use, including frequency and patterns.
7. Document any medical or treatment history that may be relevant to your assessment, such as previous detox interventions.
8. Complete the assessment by providing information on your emotional, behavioral, and cognitive conditions, including any history of mental health issues.
9. Review all sections for accuracy. Make necessary edits before saving the document.
10. After ensuring all data is complete and correct, save the completed document to your device, allowing for future downloads, printing, or sharing as needed.

Complete your MN DHS DHS-5204-ENG form online today to facilitate your assessment process.