Form DCF-4100 Extended Day Treatment Referral Form - Connecticut

Form DCF-4100 Extended Day Treatment Referral Form - Connecticut

What Is Form DCF-4100?

This is a legal form that was released by the Connecticut State Department of Children and Families - 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 the DCF-4100 Extended Day Treatment Referral Form?A: The DCF-4100 Extended Day Treatment Referral Form is a document used in Connecticut to refer individuals to extended day treatment services.

Q: What is extended day treatment?A: Extended day treatment is a type of intensive mental health service that provides therapy and support to individuals for an extended period each day.

Q: Who uses the DCF-4100 Extended Day Treatment Referral Form?A: The DCF-4100 Extended Day Treatment Referral Form is typically used by mental health professionals, such as clinicians and social workers, to refer individuals to extended day treatment.

Q: Are there any fees associated with extended day treatment?A: Fees for extended day treatment services may vary depending on the individual's insurance coverage and financial situation. It is recommended to contact the service provider for specific information on fees.

Q: What information is required on the DCF-4100 Extended Day Treatment Referral Form?A: The DCF-4100 Extended Day Treatment Referral Form typically requires information about the individual being referred, their mental health history, and the referring professional's contact details.

Q: Can I refer myself or a family member using the DCF-4100 Extended Day Treatment Referral Form?A: The DCF-4100 Extended Day Treatment Referral Form is primarily intended for use by mental health professionals. It is recommended to consult with a professional for guidance on accessing extended day treatment.

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Form Details:

  • Released on August 1, 2014;
  • The latest edition provided by the Connecticut State Department of Children and Families;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DCF-4100 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Children and Families.

Download Form DCF-4100 Extended Day Treatment Referral Form - Connecticut

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