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Rule 24 application for services (PDF) - Hennepin County ... 2025

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The document outlines the eligibility screening and determination process for Hennepin County's Substance Use Disorder (SUD) funding. It includes a comprehensive application form that collects personal information, reasons for seeking treatment, household details, income sources, and insurance information. The primary focus is on assessing the client's need for assessment or treatment services related to substance use.

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Click ‘Get Form’ to open the Rule 24 application in our editor.
Begin by entering your personal information, including your name, date of birth, and contact details. Ensure accuracy as this information is crucial for processing your application.
Fill out the section regarding your primary drug of concern and the reason for seeking assessment or treatment services. This helps in understanding your needs better.
Provide details about your household size and annual gross income. This information is essential for determining eligibility for funding.
Complete the insurance information section if applicable, and ensure you sign and date the form at the bottom before submission.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What do they do at a chemical dependency evaluation?

A chemical dependency test confirms whether an individual is physically dependent on drugs or alcohol and identifies which substances are being used. Chemical dependency evaluations also assess the severity of a substance use disorder and the extent to which it has affected the persons life.

How to get a rule 25 in Minnesota?

To apply, simply contact your countys social services department. Counties have a Rule 25 or Chemical Health department and county professionals in these can walk you through the application process.

What is the rule 25 assessment in Hennepin County MN?

What is a Rule 25 Assessment in Hennepin County MN? A Rule 25 (call 612-249-3656 for an appointment) is a meeting between a medical professional and a person that may have a substance abuse or chemical dependency problem. The evaluation occurs in Hennepin County MN and assesses your overall chemical health.

How long is a rule 25 good for MN?

The Rule 25/CD Assessment is conducted by a CD Assessor who creates an Assessment Summary and Plan that is good for 45 days.

How do I email Hennepin County health and Human Services?

To apply for assistance, call (612) 596-1300 or toll free (844) 803-8466 to apply for assistance. Pregnant Teens and Teen Parents: Call Hennepin Health Families at (612) 596-7537 or email hchealthyfamilies@hennepin.us or Public Health Nursing at (612) 617-4600.

hennepin county forms

Household Update Form Hennepin county Medical opinion form hennepin county PDF Hennepin County forms Hennepin county household report Form PDF Shelter verification form hennepin county Special diet form hennepin county Stop work verification form hennepin county mn Household Update form ramsey county

What is the mission of Hennepin County Public Health?

Hennepin County Public Health is committed to advancing health and racial equity. Mission: Advance health and racial equity through science, and prevention-focused, inclusive, public health policies, practices, and services.

How do I send forms to Hennepin County?

How to submit forms and documents and update your information Update information and upload documents to InfoKeep. Upload to MNbenefits. Fax to 612-288-2981. Mail to: Hennepin County Human Services Department. P.O. Box 107. Minneapolis, MN 55440.

What questions do they ask at a chemical assessment?

Chemical Assessment Questions Medical History Do you have any current medical concerns? Substance Use History How often do you use alcohol? Mental Health Did you experience abuse or neglect growing up? Living environment Can you tell me ho you live with? Day-to-day life What keeps you busy day-to-day?