Get Letter Of Collaboration R2 - Oklahoma Department Of Mental - Odmhsas

Filling out the Letter Of Collaboration R2 with the Oklahoma Department of Mental Health and Substance Abuse Services is essential for ensuring coordinated treatment across multiple facilities. This guide will provide you with detailed steps to complete the form online effectively.

Follow the steps to successfully complete the collaboration letter.

1. Press the ‘Get Form’ button to access the document and open it in your online editing tool.
2. Begin by filling in the names of the collaborating facilities or sites in the designated fields for Facility/Site A and Facility/Site B.
3. Enter the member’s name in the space provided, along with their recipient ID number, ensuring that the information is accurate and corresponds with your records.
4. Both collaborating facilities should detail their respective service plans in the designated spaces, explicitly concluding that each facility retains clinical control and responsibility for its part of the treatment.
5. The clinicians from both facilities must sign and date the form, indicating their agreement to collaborate, and add their credentials next to their names.
6. If the member is 14 years old or older, they should sign and date the form to consent to the treatment approach. If applicable, a parent or guardian should also provide their relationship to the member, sign, and date.
7. Fill in the division of the monthly rate as indicated by the CAR level, ensuring to record the agreed-upon CAR score level, requested split of the monthly dollar rate for both facilities, and the total dollars.
8. Review the entire document for accuracy. Once confirmed, you can save your changes, download the completed form, print it, or share it as needed.

Complete your Letter Of Collaboration online today to ensure seamless treatment coordination.