Get Department Of Mental Health And Addiction Services Dmhas

This guide provides you with clear and step-by-step instructions for filling out the Department Of Mental Health And Addiction Services (DMHAS) form online. By following these instructions, you can ensure that your information is accurately submitted for the Behavioral Health Recovery Program.

Follow the steps to successfully complete the DMHAS form.

1. Click ‘Get Form’ button to obtain the DMHAS form and open it in the editor.
2. In the designated field, enter the name of the participant. This is the person involved in the Behavioral Health Recovery Program.
3. Provide the date of birth in the appropriate format. Ensure that this information is accurate as it is crucial for identification.
4. Fill in the EMS number in the corresponding field. This number is important for administrative purposes.
5. Enter the social security number in the required section. Be cautious to input this data correctly to maintain confidentiality.
6. List the required individuals and organizations that will exchange information. This includes the DMHAS Administrative Service Organization and any referring treatment providers or service vendors.
7. Review the information that may be disclosed, ensuring it includes your relevant details such as name, address, and clinical information.
8. Read the consent statement carefully, acknowledging that your records are protected and specifying the extent of the consent.
9. Sign and date the form in the provided areas to complete your application, ensuring all information is accurate and complete.
10. Once completed, you may save changes, download, print, or share the form as needed.

Complete your DMHAS form online today to ensure timely processing of your Behavioral Health Recovery Program application.