Form MHCC-3 Physician's Emergency Certificate for No More Than 15 Days Care and Treatment in a Hospital for Psychiatric Disabilities - Connecticut

Form MHCC-3 Physician's Emergency Certificate for No More Than 15 Days Care and Treatment in a Hospital for Psychiatric Disabilities - Connecticut

What Is Form MHCC-3?

This is a legal form that was released by the Connecticut Department of Mental Health & Addiction Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form MHCC-3?
A: Form MHCC-3 is the Physician's Emergency Certificate for No More Than 15 Days Care and Treatment in a Hospital for Psychiatric Disabilities in Connecticut.

Q: What is the purpose of Form MHCC-3?
A: The purpose of Form MHCC-3 is to provide authorization for emergency psychiatric care and treatment in a hospital for a maximum of 15 days.

Q: Who can complete and sign Form MHCC-3?
A: Form MHCC-3 can only be completed and signed by a licensed physician.

Q: How long is the authorized period of care and treatment on Form MHCC-3?
A: Form MHCC-3 authorizes care and treatment in a hospital for psychiatric disabilities for a maximum of 15 days.

Q: Is Form MHCC-3 specific to Connecticut?
A: Yes, Form MHCC-3 is specific to Connecticut.

Q: Are there any fees associated with submitting Form MHCC-3?
A: There are no fees associated with submitting Form MHCC-3.

Q: Can Form MHCC-3 be submitted electronically?
A: It is recommended to submit Form MHCC-3 in person or by fax, as electronic submissions may not be accepted.

Q: Is Form MHCC-3 valid for longer than 15 days?
A: No, Form MHCC-3 is valid for a maximum of 15 days only.

Q: Can Form MHCC-3 be used for non-psychiatric hospital care?
A: No, Form MHCC-3 is specifically for care and treatment in a hospital for psychiatric disabilities.

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Form Details:

  • Released on September 1, 2008;
  • The latest edition provided by the Connecticut Department of Mental Health & Addiction Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form MHCC-3 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Mental Health & Addiction Services.

Download Form MHCC-3 Physician's Emergency Certificate for No More Than 15 Days Care and Treatment in a Hospital for Psychiatric Disabilities - Connecticut

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