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DBHIDS INTEGRATED INTAKE 2025

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4.5 out of 5

54 votes

The document outlines the DBHIDS Integrated Intake Application Packet for Behavioral Health Services in Philadelphia. It provides detailed instructions for completing a comprehensive intake form required for accessing various behavioral health services, including necessary attachments and forms. The packet emphasizes the importance of accurate completion, submission guidelines, and the criteria for eligibility for community residential services. It also includes information on priority group documentation, referral processes, and additional resources available to applicants.

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Click ‘Get Form’ to open the DBHIDS Integrated Intake in the editor.
Begin with the 'Referral Contact Person' section. Clearly enter the contact details of the person who will handle inquiries regarding this application.
In the 'Participant Name' field, input the full name (Last/First/Middle) without using nicknames. Ensure accuracy as this is a critical identifier.
Complete demographic information including gender, ethnicity, race, and sexual orientation by selecting from the provided options.
For insurance details, specify primary and secondary coverage types. Use your agency’s access to verify insurance through Pennsylvania’s Department of Public Welfare Electronic Verification System.
Fill in income sources and amounts accurately. If applicable, include the name of the payee for SSI or SSDI payments.
Proceed to document any medical issues or disabilities. Indicate if treatment has been received recently and provide necessary details.
Finally, review all sections for completeness before submitting your application through our platform for a seamless experience.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (187 Votes)
2016	4.5 Satisfied (54 Votes)

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