Get Aod/sud Intake And Assessment - Alameda County Behavioral Health ...

This guide provides step-by-step instructions for completing the AOD/SUD Intake and Assessment form online. Our aim is to assist users in accurately filling out the necessary information to facilitate their assessment and treatment process.

Follow the steps to complete the form online effectively.

1. Press the ‘Get Form’ button to access the AOD/SUD Intake and Assessment form and open it for editing.
2. Begin by entering the client's personal information. Fill in the client’s first name, last name, Medi-Cal PSP number, date of birth, preferred name, and admission date accurately.
3. Provide emergency contact information. Include the contact's name, relationship to the client, address, and phone number. Ensure that you have confirmed the release for emergency contact for the specified time period.
4. Complete the personal information section. Indicate the client's sex assigned at birth, gender identity, and preferred pronoun. Use inclusive language to reflect the client's identity.
5. Document the reason for the client's referral, including the name of the primary assigned counselor for reference.
6. Fill out the alcohol and drug history section. Mark whether the client has ever used various substances and provide details on their current use, intoxication, withdrawal status, and perceived problems.
7. Detail the client’s previous drug and/or alcohol treatment history. Include types of previous treatment, facility names, treatment dates, and completion status.
8. Input relevant medical history, including current medications, allergies, and recent medical exams. Be thorough in documenting any significant medical issues.
9. Complete the mental health history section, noting any psychiatric hospitalizations or outpatient treatments, and indicating any risk factors.
10. Address psychosocial history by identifying family, social, and economic problems that may contribute to the client’s substance use.
11. Fill in the client's education and employment history. Note the highest level of education attained and employment status, as well as any issues related to substance use affecting work.
12. Review the criminal history/legal status section, indicating any relevant legal involvement or incidents. Provide a narrative if necessary.
13. Conclude by completing the assessment items required for all perinatal programs if applicable, alongside the SUD formulation and additional comments.
14. Finalize the form by reviewing all entered information for accuracy. Users can then save changes, download, print, or share the completed form.

Complete your AOD/SUD Intake and Assessment form online to ensure a smooth intake process.