Get Mn Dhs-6791b-eng 2013-2025

The MN DHS-6791B-ENG form is essential for individuals who have undergone a MnCHOICES assessment and need to establish a community support plan for long-term services. This guide will provide clear instructions on navigating the form online to ensure all necessary information is accurately submitted.

Follow the steps to complete your MN DHS-6791B-ENG form online.

1. Click the ‘Get Form’ button to access the MN DHS-6791B-ENG form and open it in your document management system.
2. Begin by entering the person information in the designated fields. This includes first name, middle initial, last name, date of birth, and address, ensuring you provide accurate details for proper identification.
3. Input the assessment ID, home care rating, phone number, city, state, and zip code in the respective sections. Double-check the assessment date and select whether this is a new assessment or a reassessment.
4. Document the case manager or care coordinator's name, their phone number, and the name of the physician or health care provider, as well as their contact details.
5. For the support plan section, address what is important to you by listing your goals and target dates for achieving them. You can also indicate the providers responsible for reporting on your progress.
6. Assess and record your strengths and needs, as well as identify any health and safety issues. Answer the series of questions regarding your safety and needs clearly.
7. Complete the sections on home management, personal assistance, and supportive services. Indicate which supports you require and the frequency with which you will need them, specifying any relevant details for each service.
8. Fill out the section for funding the plan by selecting all applicable options. Include information about private insurance or public assistance, as necessary.
9. Review the emergency and back-up plan sections, providing contacts and plans for unforeseen events affecting your service provisions.
10. Once you have fully completed the form, save your changes. You can then download or print a copy for your records or share it with relevant parties involved in your care.

Start completing your MN DHS-6791B-ENG form online today to ensure your community support plan is in place.