Form DDD-1436A Behavioral Health Professional Consultation Summary - Arizona

Form DDD-1436A Behavioral Health Professional Consultation Summary - Arizona

What Is Form DDD-1436A?

This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of Form DDD-1436A?A: The purpose of Form DDD-1436A is to provide a summary of a behavioral health professional consultation.

Q: Who is required to fill out Form DDD-1436A?A: Behavioral health professionals are required to fill out Form DDD-1436A.

Q: What information does Form DDD-1436A include?A: Form DDD-1436A includes information on the individual receiving services, the consultation provided, and the recommendations made.

Q: Is Form DDD-1436A specific to Arizona?A: Yes, Form DDD-1436A is specific to Arizona.

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Form Details:

  • Released on April 1, 2021;
  • The latest edition provided by the Arizona Department of Economic Security;
  • 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 fillable version of Form DDD-1436A by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.

Download Form DDD-1436A Behavioral Health Professional Consultation Summary - Arizona

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