Get Medication Informed Consent Document - Magellan Rx Management

Completing the Medication Informed Consent Document is an essential step in managing behavioral or psychiatric conditions. This guide will provide you with clear and concise instructions to navigate each section of the form and ensure a smooth online process.

Follow the steps to successfully fill out the consent document.

1. Click ‘Get Form’ button to obtain the Medication Informed Consent Document and open it in the editor.
2. Begin by entering the Physician AR Medicaid ID Number and the Recipient Medicaid ID Number in the designated fields. Ensure these numbers are accurate to avoid any processing issues.
3. Next, fill in the Physician Name and Patient Name fields. It is important to provide the full name of both individuals for proper identification.
4. Complete the Address section, including Street Address, City, State, and Zip Code. Make sure all details are correct to facilitate communication and coordination.
5. Enter the Patient's Date of Birth in the specified format, ensuring it reflects the correct birth date to match the patient's records.
6. Review the Parental/Guardian Consent Statement section carefully. Acknowledge each point by ensuring you understand the implications of treatment, medication options, and potential side effects.
7. In the Provider Section, specify the targeted symptoms that the provider has identified for treatment. Ensure to include comprehensive evaluations performed and indicate if any past evaluations were done.
8. Fill out the Medication Recommendation section, detailing the dose and dosing instructions clearly. This information is crucial for ensuring safe medication management.
9. In the section regarding the explanation of risks and benefits, indicate the method of communication used (Phone or Face-to-Face) to confirm that it was discussed with the parent/guardian.
10. Finalize the form by having the Physician, Nurse, or Physician Assistant sign and print their name, including the time and date of signing. Ensure that a manual signature is provided as rubber stamps are not permitted.
11. The parent or guardian must then sign, date, and provide their relationship to the patient, followed by a witness signature with the respective date and time.
12. Once all fields are complete, save your changes. You may choose to download, print, or share the form as needed.

Start filling out your Medication Informed Consent Document online today for efficient management of your health care needs.