South Dakota Medicaid at-Risk Referral Form is a legal document that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota.
Q: What is the South Dakota Medicaid at-Risk Referral Form?
A: The South Dakota Medicaid at-Risk Referral Form is a document used to refer individuals who may have risk factors for certain health conditions to Medicaid for further evaluation and assistance.
Q: Who can use the South Dakota Medicaid at-Risk Referral Form?
A: Healthcare providers, social workers, and other professionals who work with individuals at risk for certain health conditions can use the South Dakota Medicaid at-Risk Referral Form to refer them for further evaluation and assistance.
Q: What are the risk factors for which an individual can be referred using this form?
A: The South Dakota Medicaid at-Risk Referral Form can be used to refer individuals at risk for conditions like diabetes, obesity, hypertension, tobacco use, substance abuse, and mental health disorders.
Q: What information is required on the South Dakota Medicaid at-Risk Referral Form?
A: The form typically requires information about the individual being referred, their contact details, information about their risk factors, and any additional relevant information that might help with the evaluation.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.