Get Contra Costa Mhc113 2017-2026

The Contra Costa MHC113 is an essential document for conducting an initial psychiatric assessment. This guide provides clear and supportive instructions for filling out the form online, ensuring that all users, regardless of their legal experience, can complete it effectively.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the MHC113 and access it digitally for completion.
2. Fill in the 'Date of Service' with the current date. Provide 'RU' and 'Staff #' as applicable. Indicate the hours and minutes spent on the assessment.
3. Select the location of the service by checking one of the options such as 'Office', 'Field', or 'Home'. If the location does not fit, choose 'Other'.
4. In the 'Service Strategies' section, check up to three strategies that apply to the assessment, such as 'Peer/Fam Deliv Svcs' or 'Psych Education'.
5. If an interpreter is needed, indicate the language in which the assessment is conducted and provide the name of the interpreter, if applicable.
6. Complete the 'Identifying Information' section, including legal name, age, date of birth, preferred name, gender, and marital status.
7. Provide the address and phone number of the client. Include emergency contact details as well.
8. Outline the primary concerns from the consumer's perspective and provide a narrative on the presenting problem or recent course of illness.
9. Document consumer and family strengths that may facilitate treatment and detail psychiatric history, including any hospitalizations or interventions.
10. Fill in the psychiatric medication history, ensuring to list both current and past medications, alongside any observed side effects.
11. Assess and document all substance use history, checking each applicable substance and providing additional details in the space provided.
12. Record medical history, including relevant illnesses, surgeries, allergies, and the date of the last physical examination.
13. Complete the psychosocial history, noting any significant factors such as education, family background, and any relevant legal involvement.
14. Conduct a mental status examination by evaluating and documenting various domains such as appearance, speech, and mood.
15. Fill in the current risk assessment, monitoring any potential danger to self or others, and document any findings.
16. Conclude with the clinical summary, making a diagnostic impression and detailing any treatment plans.
17. Review the entire form for completion and accuracy. Once finalized, you may download, print, or share your completed document.

Start filling out your Contra Costa MHC113 online today for a smoother assessment process.