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Dhs 3244p eng 2011 form-2026
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- Click ‘Get Form’ to open the DHS-3244P-ENG form in the editor.
- Begin by entering the 'Date of Referral' in mm/dd/yy format. Indicate whether this is for an 'Initial Assessment' or 'Reassessment' by checking the appropriate box.
- Fill out the recipient information section completely, including name, address, phone number, and date of birth. Ensure all fields are legible to avoid delays.
- Verify eligibility through EVS by entering the verification date and selecting the major program applicable to the recipient.
- Complete the physician information section with details about the recipient's physician and clinic, ensuring accuracy for effective communication.
- In the PCA provider(s) information section, provide details about your agency and include NPI/UMPI codes as required.
- Address language needs by indicating if an interpreter is necessary and specify any additional comments regarding living arrangements or diagnosis.
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