Loading
Get Kaiser Permanente 02334-040 2014-2025
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Kaiser Permanente 02334-040 online
Filling out the Kaiser Permanente 02334-040 form is a crucial step in assessing your mental health. This guide will provide you with clear, step-by-step instructions to help you conveniently complete the form online.
Follow the steps to accurately fill out the Kaiser Permanente 02334-040 form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your medical record number at the designated section to ensure accurate identification.
- Provide your name in the relevant field to personalize the form.
- For each question regarding your mental health over the last two weeks, circle the number that best reflects your experience. The options range from 0 (not at all) to 3 (nearly every day).
- After completing all questions in the PHQ-9 section, add the circled numbers in each column, then calculate the total for 'Global Distress Score (GDS)'. This will help determine the level of distress.
- Next, review the relationship section, where you will answer yes, no, or prefer not to answer for safety-related questions pertaining to your partner.
- Double-check all your entries for accuracy and completeness before proceeding.
- Once satisfied with your entries, you can save your changes, download the form, print it for your records, or share it as needed.
Complete your Kaiser Permanente 02334-040 form online today to take an important step towards your mental health.
Related links form
The number 800 464 4000 is the customer service line for Kaiser Permanente. When you call, you will reach representatives who can assist you with your health needs, including questions about Medi-Cal. This line is a valuable resource for anyone connected to Kaiser Permanente 02334-040.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.