3877 form-2025

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The document is a bulletin from the Michigan Department of Community Health that announces revisions to the Preadmission Screening (PAS) and Annual Resident Review (ARR) forms, specifically the DCH-3877 and DCH-3878. It details changes in terminology, updates to diagnostic criteria, and instructions for ordering the revised forms. The bulletin also outlines the process for completing these forms to identify individuals with mental illness or developmental disabilities who may require further evaluation or exemption from additional screenings.

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Click ‘Get Form’ to open the DCH-3877 in the editor.
Begin by filling out Section I with patient information, including name, date of birth, gender, and address. Ensure all fields are accurately completed.
Indicate if the patient has a court-appointed guardian by selecting 'YES' or 'NO'. If 'YES', provide the guardian's details.
In Section II, answer all six screening criteria questions. Circle 'YES' or 'NO' as applicable and provide explanations for any 'YES' answers.
Complete Section III with the clinician’s statement. The clinician must sign and date this section to certify the accuracy of the information provided.
Review all entries for completeness and accuracy before saving or printing your completed form.

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Versions	Form popularity	Fillable & printable
2022	4.5 Satisfied (39 Votes)
2021	4.8 Satisfied (205 Votes)
2019	4.2 Satisfied (69 Votes)
2007	4.6 Satisfied (45 Votes)
2003	4.2 Satisfied (51 Votes)

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How do I get proof that I mailed something?

Use a Certificate of Mailing. Certificate of Mailing service provides a postmarked mailing receipt as evidence that your item was mailed. This is all you need to do: Complete PS Form 3817 at the time of mailing.

What is an example of accountable mail?

Referred to as such by the USPS, Accountable Mail will include all US Express, Delivery Confirmation, Signature Confirmation, Certified, Registered, and Insured Mail. Certified Mail provides a mailing receipt and a record of delivery is maintained at the recipients post office.

How much is the PS 3817 fee?

The fee for certificates of mailing for ordinary letter-post and ordinary parcel post is $0.95 per piece whether the item is listed individually on PS Form 3817 Certificate of Mailing or on firm mailing bills. Additional copies of PS Form 3817 or firm mailing bills are available for $0.95 per page.

What is PS Form 3877 used for?

USPS Firm Mailing Book (Form 3877) is a list of ERR mailpieces you printed for the day. You take this form to the Post Office along with your ERR items to be stamped as proof that you dropped the items off.

What is USPS Form 3877?

PS Form 3877 is a multipage bound book that contains individual sheets with space to enter multiple article numbers for accountable mail such as Certified Mail, COD, Priority Mail Express and insured mail pieces. Note: the use of the book eliminates the need to generate individual mailing receipts for each article.

3877

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What is a 3877 form?

PS Form 3877, Firm Mailing Book for Accountable Mail, is a multipage bound book used to mailing multiple pieces of mail at the same time that have Extra Services such as Certified Mail, COD, Priority Mail Express, and Insured Mail pieces.

What is the difference between a certificate of mailing and certified mail?

What is the difference? A certificate of mailing only proves that mail was shipped on a certain date, but it does not prove or confirm that the mail was delivered. Certified mail provides proof that the mail was shipped AND delivered.