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Personal care screening tool form 2026

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  1. Click ‘Get Form’ to open the personal care screening tool form in the editor.
  2. Begin by entering the name of your Medicaid Certified Provider and the corresponding Medicaid Provider Number in the designated fields.
  3. Fill in your contact information, including your name, telephone number, and email address.
  4. Indicate whether your agency will perform Personal Care Screens directly by selecting 'Yes' or 'No'.
  5. Answer if your agency is already established for other screens (Adult Long Term Care, Children’s Long Term Support, or Mental Health/AODA) by selecting 'Yes' or 'No'.
  6. If contract agencies will conduct Personal Care Screens on behalf of your provider, select 'Yes' and provide their names and contact information in the specified fields.
  7. Finally, submit your application by sending it to the provided contact via email or fax as indicated at the bottom of the form.

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Personal Care Screening Tool (PCST)
The Malnutrition Universal Screening Tool (MUST) has been designed to help identify adults who are underweight and at risk of malnutrition, as well as those who are obese. It has not been designed to detect deficiencies in or excessive intakes of vitamins and minerals.
Parents Evaluations of Developmental Status-Revised or PEDS-R is an evidence-based method for detecting and addressing developmental, behavioural and social-emotional/mental health concerns in children under eight years.
(PRAPARE) is a national standardized patient risk assessment tool designed to engage patients in assessing addressing social drivers of health (SDOH).
PRAPARE measures the following core categories: Personal Characteristics: Race, Ethnicity, Farmworker Status, Language Preference, veteran Status. Family and Home: Housing Status and Stability, Neighborhood. Money and Resources: Education, Employment, Insurance Status, Income, Material Security.

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