Form DDD-2104A Member Interdisciplinary Team Summary - Arizona

What Is Form DDD-2104A?

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 Form DDD-2104A?
A: Form DDD-2104A is the Member Interdisciplinary Team Summary used in Arizona.

Q: What is the purpose of Form DDD-2104A?
A: The purpose of Form DDD-2104A is to summarize and document the information gathered by the interdisciplinary team for a member receiving developmental disabilities services in Arizona.

Q: Who completes Form DDD-2104A?
A: The interdisciplinary team, which includes professionals and providers involved in the member's care, completes Form DDD-2104A.

Q: What information is included in Form DDD-2104A?
A: Form DDD-2104A includes information about the member's diagnosis, functional and behavioral status, support needs, goals, and recommendations for services and supports.

Q: Why is Form DDD-2104A important?
A: Form DDD-2104A is important because it ensures that the member's needs, goals, and recommended services and supports are properly documented and communicated within the interdisciplinary team.

Q: When is Form DDD-2104A used?
A: Form DDD-2104A is used when completing the initial assessment, annual reassessment, or significant change in the member's condition or circumstances.

Q: Can Form DDD-2104A be updated or modified?
A: Yes, Form DDD-2104A can be updated or modified as needed to reflect changes in the member's condition, goals, or recommended services and supports.

Q: Who should I contact if I have questions or need assistance with Form DDD-2104A?
A: If you have questions or need assistance with Form DDD-2104A, you should contact the Arizona Department of Economic Security's Division of Developmental Disabilities (DDD) or your assigned support coordinator.