Get Mn Dhs-6249-eng 2010

The MN DHS-6249-ENG is an essential form used by mental health providers to document assessments and recommendations for individuals receiving care. This guide provides step-by-step instructions on how to complete the form online, ensuring that you enter all necessary information accurately and efficiently.

Follow the steps to fill out the MN DHS-6249-ENG effectively.

1. Click the ‘Get Form’ button to access the MN DHS-6249-ENG and open it in your preferred editor.
2. Enter the date of assessment in the designated field. This should reflect the date when the assessment was completed.
3. Fill in the recipient's date of birth using the format Month/Day/Year (MM/DD/YYYY).
4. Select the recipient's gender by marking either 'Male' or 'Female'.
5. Input the recipient's PMI number or Social Security number, with a preference for the PMI number.
6. Write in the diagnosis, ensuring you include the full diagnostic name or the ICD-9 code where applicable.
7. Complete the provider name and National Provider Identifier (NPI). Specify the type of service being provided.
8. For the 'Actual Level of Care Provided', indicate the care level the recipient is receiving, which may differ from the recommended level.
9. List any services the recipient is currently receiving or has been referred to, such as ARMHS or case management.
10. If applicable, provide a reason for any variance from the recommended level of care, including a brief clinical justification.
11. Determine and write down the composite score by adding the scores from each dimension.
12. Sign the form where required. If completed by a Mental Health (Rehab) Professional, a supervisor's signature is not necessary.
13. Review all the information to ensure accuracy, then save changes, download, print, or share the completed form as needed.

Complete your forms online to enhance efficiency and ensure accurate documentation.