Authorization Number : 580-0831
Agency Series No. : FIS-014H
Status : Active
Agency Web Link :
Agency : DMH
Confidential Description : N/A-Load
Division :
Vital Description :
Section :
Record Title : CLIENT NEEDS ASSESSMENT
Revision : 0
Record Description : (CA-002) Form completed in the hospital by the patient's treatment team listing items that patient needs such as clothing, personal items, weekly allowance, etc. The forms are completed for patients for whom the hospital is the representative payee (recipient) of their funds. If these are filed in the medical/clinical record, then must be kept for the same period of time as the medical clinical record.