Home
Forms Library
Stop work form hennepin county

Get the up-to-date Rule 24 application for services (PDF) - Hennepin County ... 2025 now

stop work form hennepin county Preview on Page 1

Show details

4.7 out of 5

48 votes

The document outlines the eligibility screening and determination process for Hennepin County's assessment and treatment services related to substance use disorder (SUD). It includes a comprehensive application form that collects personal information, reasons for seeking services, household details, income sources, and insurance information. The primary focus is on gathering necessary data to assess eligibility for funding through the SUD CCDTF/BH program.

Here's how it works

01. Edit your stop work form hennepin county online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send hennepin county stop work form via email, link, or fax. You can also download it, export it or print it out.

The best way to edit Rule 24 application for services (PDF) - Hennepin County ... online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making adjustments to your documentation takes only a few simple clicks. Make these fast steps to edit the PDF Rule 24 application for services (PDF) - Hennepin County ... online for free:

Register and log in to your account. Log in to the editor with your credentials or click on Create free account to evaluate the tool’s functionality.
Add the Rule 24 application for services (PDF) - Hennepin County ... for editing. Click the New Document option above, then drag and drop the document to the upload area, import it from the cloud, or via a link.
Alter your template. Make any adjustments required: insert text and photos to your Rule 24 application for services (PDF) - Hennepin County ..., highlight details that matter, remove sections of content and replace them with new ones, and add symbols, checkmarks, and areas for filling out.
Finish redacting the template. Save the updated document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is very intuitive and effective. Try it now!

See more Rule 24 application for services (PDF) - Hennepin County ... versions

We've got more versions of the Rule 24 application for services (PDF) - Hennepin County ... form. Select the right Rule 24 application for services (PDF) - Hennepin County ... version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2020	4.7 Satisfied (48 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

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

ACT team Hennepin County Hennepin County psychological services Hennepin County DART Hennepin County case worker Hennepin County partners page Hennepin County Plus program Hennepin County LAC Hcmc case management

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?