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The document is a certification form for Qualified Health Professionals in Kentucky, used for involuntary treatment of individuals with substance use disorders. It outlines the responsibilities of the affiant, who must assess the respondent's condition and determine if they suffer from a substance use disorder, present an imminent threat to themselves or others, and can benefit from treatment. The form requires detailed findings, diagnostic impressions, and recommendations for treatment, along with specific qualifications for health professionals involved.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (91 Votes)
2017	4.4 Satisfied (197 Votes)
2006	4.3 Satisfied (269 Votes)

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