Get Ar Dco-0108c 2018-2025

Filling out the AR DCO-0108C online is a critical process for submitting a medical review request for children. This guide will provide clear and structured instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully fill out the AR DCO-0108C form.

1. Click the ‘Get Form’ button to access the AR DCO-0108C form and open it in your preferred online document editor.
2. In Section 1, fill out the information required by the eligibility worker, including the child's budget unit ID, the application date, and the child's name. Ensure that all entries are accurate and complete.
3. Continue in Section 1 by providing additional details such as the child's race, casehead name, address, birthdate, county, and worker’s name as shown in their email. Include the last MRT decision date, interview date, and the date routed to MRT.
4. Move to Section 2, which is designated for MRT use only. As needed, provide the date records were added, MRT date, date medical records request was sent, and all related medical record information.
5. In Section 3, begin with part A, where you must list all household members. Provide the necessary details for each member, including last name, first name, relationship to the child, age, and any relevant codes.
6. Next, under part B, describe the physical and mental conditions of the child. Include specific information regarding height, weight, onset of the condition, and any prior applications for SSI or Social Security Disability.
7. Answer further questions in part B regarding medical treatment received, educational attendance, and any behavioral issues or therapy the child has undergone, ensuring that all questions are addressed thoroughly.
8. Document any details regarding physician or clinic information in the designated sections, including names, addresses, and phone numbers of medical professionals involved with the child's care.
9. Ensure that you check the attachments required at the end of the form, such as the completed DHS-4000 forms and any available medical records.

Begin completing the AR DCO-0108C online today to streamline your submission process.