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Get MN DHS-2794-ENG 2013-2024

He least restrictive referral consistent with sound clinical judgment. All items must be clearly documented in the Assessment Tool. This form must remain in the client file. Check the severity rating for each dimension and document the provider(s) who will meet the identified needs. Dimension I Intoxication/ Withdrawal II Biomedical III Emotional/ Behavioral/ Cognitive IV Readiness for Change V Relapse and Continued Use VI Recovery Environment Severity Rating  0  1  2  3  4 = Crisis  .

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