Get Magellan Health Services Therapeutic Leave Pass And Bed Hold Form 2008-2025

Filling out the Magellan Health Services Therapeutic Leave Pass And Bed Hold Form can be a simple process when approached step-by-step. This guide will help you understand each component of the form and how to complete it online with confidence.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in your document editor.
2. Fill in the 'Facility Name' section with the name of the healthcare facility you are associated with.
3. Enter the 'Recipient Name' accurately to identify the person requesting the therapeutic leave.
4. Provide the 'DOB' (date of birth) of the recipient to ensure identification clarity.
5. In the 'Dates Requested' section, specify the 'Start Date' and 'End Date' for the therapeutic leave pass.
6. Outline the 'Goal and Objective of the Pass', ensuring it is clear and directly related to the recipient’s treatment.
7. Indicate the 'Specific Goal in the Treatment Plan' that aligns with the overall objective of the leave pass.
8. For the bed hold request, include the name of the facility confirming that they understand the purpose of the hospitalization.
9. Complete the section for the printed name and title of the facility representative who will authorize this request.
10. Have the facility representative add their signature to validate the request.
11. Finalize the process by saving your changes, downloading, printing, or sharing the form as needed.

Start filling out the Magellan Health Services Therapeutic Leave Pass And Bed Hold Form online today!