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Get Il Cfs 431-a 2006
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How to fill out the IL CFS 431-A online
The IL CFS 431-A is a psychotropic medication request form used by the Illinois Department of Children & Family Services. This guide will assist you with step-by-step instructions on how to complete the form accurately online.
Follow the steps to complete the IL CFS 431-A form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the date of the request at the top of the form. This is crucial for record-keeping and tracking purposes.
- Fill in the child’s name and indicate their gender by checking the appropriate box. Provide the date of birth and place of placement, such as foster care or residential facility.
- Input the CFS ID#, current height, and weight of the child. Include details regarding the ethnicity and contact number if applicable.
- Provide the address of the facility or caregiver and list the prescribing physician’s name along with their contact number and fax number.
- In the clinical information section, detail any concurrent medical diagnoses and all psychiatric diagnoses that the child has.
- List the current psychotropic medications the child is taking, including dosage and frequency. Continue for all medications as needed.
- Document any discontinued psychotropic medications the child has used, along with their dosages and frequency.
- In the medication request section, select the type of request by checking the appropriate box: new, increase, renewal, resume, or one-time order. If applicable, include the current dosage for increase or renewal requests.
- Provide details about the medication requested, including the brand name, chemical name, dosage, frequency, duration, and symptom details related to the request.
- List any tests or procedures required prior to or during monitoring of the requested medication.
- Document alternative treatments or medications considered or attempted, along with reasons for their rejection.
- Ensure that you review potential side effects with the child and indicate whether the child objects to the medication if they are 12 years of age or older.
- Once all fields are completed, you can save changes, download, print, or share the form as needed.
Complete your IL CFS 431-A form online today to facilitate timely medication requests.
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