Get Dbhds Forms

Filling out the Dbhds Forms is a crucial process for reporting serious incidents or injuries in licensed programs. This guide provides step-by-step instructions to ensure that users complete the form accurately and efficiently.

Follow the steps to complete the Dbhds Forms seamlessly.

1. Click the ‘Get Form’ button to obtain the form and access it for online completion.
2. Enter the organization name in the designated field at the beginning of the form.
3. Fill in the service name where the incident or death occurred, followed by the service number.
4. Provide the location address, including city, state, and zip code.
5. Complete the consumer's name, including first name, middle initial, and last name.
6. Input the date of birth of the consumer using the specified format.
7. Indicate the consumer's ethnicity/race and gender.
8. Enter the Medicaid number if applicable.
9. Date of the death or incident should be entered next.
10. Specify whether the consumer is a waiver service recipient and select the appropriate waiver type.
11. Indicate the date of discovery of the incident or death, along with the time it occurred.
12. If filling out for serious injuries, check all applicable types of injuries in the section provided.
13. For serious incidents, check all applicable incidents listed.
14. Answer the questions regarding loss of consciousness and whether medical attention was provided.
15. If reporting a death, complete the section asking about the nature of the death and its expectations.
16. Provide additional information regarding known facts related to the incident or death, and attach notes if necessary.
17. Indicate if there were allegations of abuse or neglect, and complete any necessary follow-up fields.
18. Document any external notifications made, such as to law enforcement or health departments.
19. Complete the licensing specialist section, including action taken and dates.
20. After reviewing all entries, save your changes, download, print, or share the completed form as necessary.

Complete your Dbhds Forms online today to ensure all incidents are reported promptly and accurately.