Form F-11048 Certification of Need for Emergency Psychiatric / Substance Abuse Admissions to Hospital Institutions for Mental Disease for Members Under Age 21 and in Case of Medicaid Determination After Admission - Wisconsin

Form F-11048 Certification of Need for Emergency Psychiatric / Substance Abuse Admissions to Hospital Institutions for Mental Disease for Members Under Age 21 and in Case of Medicaid Determination After Admission - Wisconsin

What Is Form F-11048?

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

FAQ

Q: What is Form F-11048?
A: Form F-11048 is a certification form for emergency psychiatric/substance abuse admissions to hospital institutions for mental disease (IMD) for individuals under the age of 21 in Wisconsin.

Q: Who is this form for?
A: This form is for individuals under the age of 21 who require emergency psychiatric or substance abuse admissions to hospital IMDs in Wisconsin.

Q: What is the purpose of Form F-11048?
A: The purpose of this form is to certify the need for emergency admissions to hospital IMDs for individuals under the age of 21 who require psychiatric or substance abuse treatment.

Q: When is this form used?
A: This form is used when there is a need for emergency psychiatric or substance abuse admissions to hospital IMDs for individuals under the age of 21 in Wisconsin.

Q: Is this form specific to Wisconsin?
A: Yes, this form is specific to emergency psychiatric/substance abuse admissions for individuals under the age of 21 in Wisconsin.

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Form Details:

  • Released on February 1, 2009;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • 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 F-11048 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-11048 Certification of Need for Emergency Psychiatric / Substance Abuse Admissions to Hospital Institutions for Mental Disease for Members Under Age 21 and in Case of Medicaid Determination After Admission - Wisconsin

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  • Form F-11048 Certification of Need for Emergency Psychiatric / Substance Abuse Admissions to Hospital Institutions for Mental Disease for Members Under Age 21 and in Case of Medicaid Determination After Admission - Wisconsin, Page 1
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