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Form CSO-1364C Statement From Medical Director / Designee of Residential Treatment Center (Bhif-Rtc) - Arizona
What Is Form CSO-1364C?
This is a legal form that was released by the Arizona Department of Child Safety - 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 CSO-1364C?
A: Form CSO-1364C is a statement from the Medical Director/Designee of a Residential Treatment Center (BHIF-RTC) in Arizona.
Q: Who should fill out Form CSO-1364C?
A: The Medical Director/Designee of the Residential Treatment Center (BHIF-RTC) should fill out Form CSO-1364C.
Q: What is the purpose of the Residential Treatment Center?
A: The purpose of the Residential Treatment Center is not specified in the document.
Q: What information does Form CSO-1364C include?
A: Form CSO-1364C includes information from the Medical Director/Designee of the Residential Treatment Center (BHIF-RTC) like name, title, facility name, and signature.
Form Details:
- Released on September 1, 2022;
- The latest edition provided by the Arizona Department of Child Safety;
- 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 CSO-1364C by clicking the link below or browse more documents and templates provided by the Arizona Department of Child Safety.
