Get Ca Dhcs 5086 2017

The CA DHCS 5086 form is essential for applicants to submit their weekly schedule of alcohol and drug recovery treatment services. This guide will provide a straightforward walkthrough to help users complete the form accurately.

Follow the steps to fill out the CA DHCS 5086 form effectively.

1. Click the ‘Get Form’ button to obtain the CA DHCS 5086 form and open it in your preferred online document editor.
2. Enter the facility name and provider number in the designated fields at the top of the form to clearly identify your services.
3. Complete the weekly activities schedule by filling in the time slots for each day of the week. Use abbreviations for groups sessions (GS), individual sessions (IS), educational sessions (ES), and other treatment modalities.
4. For each day from Monday to Sunday, specify the time dedicated to treatment planning (TP) and recovery planning (RP) as needed.
5. Ensure that the daily total hours of services provided are calculated accurately and reflected in the 'Daily Total Hours' section.
6. At the end of the week, total the hours for services provided across all days in the 'Total hours per week of services provided' field.
7. Review your entries for accuracy before finalizing. Once completed, you can save changes, download, print, or share the form as necessary.

Start filling out the CA DHCS 5086 online today to ensure your compliance with the necessary recovery treatment services schedule.