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Click ‘Get Form’ to open the PASRR Level I identification form in the editor.
Begin with Section I – Demographics. Fill in the applicant's Social Security Number, completion date, and full name. Ensure accuracy as this information is crucial for identification.
Proceed to Section II – Neurocognitive Disorder. Answer whether the individual has a diagnosis of Mild or Major NCD and provide any corroborative testing information if applicable.
In Section III – Mental Health, indicate if there is a mental health condition present. List any diagnoses and treatment history that may require further evaluation.
Continue through Sections IV to VII, providing necessary details about intellectual disabilities, other related conditions, and exceptional admissions criteria as required.
Finally, complete Section VIII by checking the appropriate screening outcome and ensure all signatures are obtained in Section IX before submission.
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