Get Dcf 465 Form

The Dcf 465 form is essential for obtaining consent for psychotropic medication requests for children committed to the Department of Children and Families (DCF). This guide provides clear, step-by-step instructions on how to complete the form online, ensuring that you're equipped with the necessary information to navigate the process effectively.

Follow the steps to fill out the Dcf 465 form online

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Enter the child's name, date of birth, and gender in Section I. This information identifies the child for whom medication consent is being requested. Ensure all details are accurate.
3. Input the prescriber's name and telephone number. Include the return response fax number and email address where the decision will be sent. If the contact person differs from the prescriber, include their name and telephone number.
4. In Section II, select the child's current placement from the available options such as hospital, foster home, or group home. Provide the name of the treatment setting and detail the date last seen by the prescriber including information on the type of assessment conducted.
5. Section III requires you to check all relevant reasons for the psychotropic medication request. Options include dosage adjustments, new medications, or requests for non-DCF approved medications.
6. List current medications in Section IV, including both psychotropic and non-psychotropic medications, and document any known allergies.
7. In Section V, provide a clear list of the child’s primary psychiatric and medical diagnoses according to the DSM-V.
8. Summarize the reason for the medication request in Section VI. This should be a concise and clear explanation.
9. Detail the requested medication changes, dosages, and target symptoms in Section VII. Clearly outline any cross taper plans.
10. Section VIII is for monitoring studies. Complete the required baseline studies and document any abnormal results, ensuring that all guidelines are adhered to.
11. Once all sections are filled out correctly, save your changes. You can then download, print, or share the completed Dcf 465 form as required. Ensure it is sent to the appropriate fax number or email as instructed.

Complete and submit your Dcf 465 form online for efficient processing.