Me MI Healthy Beginnings Postpartum Assessment Date of Birth Month Race Black/African American White/Caucasian Asian American Indian or Year Native Hawaiian/Other Pacific Islander Biracial Other Unknown Alaska Native Ethnic Origin Day Hispanic Non-Hispanic Not Identified County of Residence Home Address: Address change on Contact Update Log Client ID# Date Form Initiated: Month Day Year Staff Init.
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How to fill out the NC DHHS 4142 online
This guide provides comprehensive steps to assist you in filling out the NC DHHS 4142 form online. Designed for users ranging from first-timers to those familiar with online document management, it aims to ensure a smooth and accurate submission.
Follow the steps to successfully complete the form online.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Begin filling out the participant information, including the last name, first name, middle initial, date of birth, and race. Make sure to select the appropriate options in the race section and fill in the date accurately.
- Provide details regarding county of residence and home address. If there has been an address change, check the relevant option in the contact update log.
- Enter the client ID number, initiation date of the form, and staff initials. Indicate the contact type by selecting the appropriate method (phone, home visit, office, etc.).
- Indicate whether the participant is enrolled in another program by checking ‘Yes’ or ‘No’ and providing details if applicable. Confirm the listed programs to avoid duplication of services.
- Fill in the participant's phone numbers, noting preferred contact methods. Indicate whether the participant can receive text messages.
- Document whether interpreter services are needed and specify the preferred language for communication.
- Complete information about the participant’s highest level of education and whether they have health insurance. If applicable, include any details about primary care providers.
- Respond to questions regarding the participant's employment status, transportation needs, and current birth control method.
- Detail information about the baby, including name, gender, due date, and birth weight. Include breastfeeding details and follow-up postpartum care questions.
- Conclude by filling out screening questions regarding tobacco use, substance use, and any experiences with intimate partner violence.
- Make sure to check the financial and housing questions to provide a complete assessment of the participant’s situation.
- Document any coordinated support services and add any additional notes at the end of the form to ensure all relevant information is collected.
- Once you have filled out all the necessary fields, you can save your changes, download the form, print it for your records, or share it as required.
Start filling out your documents online today to ensure timely submission and support.
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What does the NC DHHs do?
The Department of Health and Human Services manages the delivery of health- and human-related services for all North Carolinians, especially our most vulnerable people – children, elderly, disabled and low-income families.
What is NC Dhhs CST service?
Community Support Team (CST) provides direct support to adults with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) diagnosis of mental illness, substance use, or co- morbid disorder and who have complex and extensive treatment needs.
Where is the new headquarters of the NC Dhhs?
The 11-story tower and 900-space parking deck will rise on the corner of Blue Ridge and Reedy Creek roads, across from the N.C. Museum of Art. The state hopes to move 2,500 DHHS employees from the Dorothea Dix campus into the new building by the summer of 2025.
What is CST in NC?
Getting Started Central Standard Time (CST) to Charlotte, North Carolina ( in Charlotte) 1 pm CST is 2 pm in Charlotte 2 pm CST is 3 pm in Charlotte 3 pm CST is 4 pm in Charlotte 4 pm CST is 5 pm in Charlotte8 more rows
What is a Ncdhhs CST service?
Community Support Team CST services consist of community-based mental health and substance abuse rehabilitation services and necessary supports provided through a team approach to assist adults in achieving rehabilitative and recovery goals.
What does NC Dhhs do?
The Department of Health and Human Services manages the delivery of health- and human-related services for all North Carolinians, especially our most vulnerable people – children, elderly, disabled and low-income families.
What does CST stand for in mental health?
Community Support Team (CST) The Community Support Team ( CST ) provides service to individuals with mental health needs that respond to an assertive and intensive team-based approach.
What is the NC Dhhs rapid response team?
Coordinated by Child Behavioral Health Unit, the Rapid Response Team includes representatives from the Division of Social Services, Division of Health Benefits/NC Medicaid, Division of Mental Health/Developmental Disabilities/Substance Use Services, and Division of State Operated Health Facilities.
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