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Hudson River Region Forms

One of Community Care's goals is to keep the clinical review between our Care Monitors and inpatient mental health, detoxification and rehab provider staff simple but comprehensive. To this end, we have created clinical review templates that can be used to guide our clinical discussions pertaining to medical necessity and discharge planning. Provider reviewers can prepare for clinical reviews with Care Monitors by referring to the templates to determine what information may be addressed.

Community Care is mindful of providers' time constraints so the review templates have been designed to expedite the review process. The majority of information obtained from the previous review will populate on the current review template. Care Monitors will be able to make changes to outdated information without having to repeat the same questions at each review.

Please note that the templates are guides for telephonic collection and discussion of clinical information and should not be faxed.

Provider Forms
Initial Mental Health Template 380 KB 8 pages PDF
Initial Rehabilitation Template 369 KB 7 pages PDF
Initial Detoxification Template 410 KB 8 pages PDF
Discharge Template 406 KB 7 pages PDF
Outreach Template 225 KB 2 pages PDF


Release of Information
Guidance Memo - Confidentiality 525 KB 4 pages PDF
Release of Information 100 KB 1 page PDF