PM FORM 3147 Out-of-Home OOH Discharge Plan -Adult-2025

1. Click ‘Get Form’ to open the PM FORM 3147 in our editor.
2. Begin by filling out the OOH Service section. Select the appropriate service type by checking either 'Behavioral Health Supportive Home' or 'Behavioral Health Residential Facility'.
3. In the Provider Information section, enter details such as the name of the intake agency, case manager, and discharge planner along with their contact information.
4. Complete the Member Information section by providing the member's name, date of birth, admission date, discharge date, and where they are being discharged to.
5. For Aftercare Information, indicate if the member is returning to a family residence. If yes, specify family support interventions including provider names and target symptoms.
6. List aftercare services such as outpatient therapies and psychiatric medication management. Be sure to include provider names and appointment frequencies.
7. Fill in any additional appointments for case management, group therapy, individual therapy, and peer support with relevant provider details and times.
8. Finally, ensure all information is accurate before sending it securely via email as indicated at the bottom of the form.

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