National children s mental health day

    • [PDF File]Vaccine Information Statement: Inactivated Influenza Vaccine

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      Influenza vaccine can prevent influenza (flu). Flu is a contagious disease that spreads around the United States every year, usually between October and May. Anyone can get the flu, but it is more dangerous for some people. Infants and young children, people 65 years of age and older, pregnant women, and people with certain health conditions or

    • [PDF File]PHQ-9* Questionnaire for Depression Scoring and ...

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      PHQ-9* Questionnaire for Depression Scoring and Interpretation Guide For physician use only Scoring: Count the number (#) of boxes checked in a column. Multiply that number by the value indicated below, then add the subtotal to produce a total score. The possible range is 0-27. Use the table below to interpret the PHQ-9 score.

    • [PDF File]Patient Health Questionnaire (PHQ-9)

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      2. Add up 3s by column. For every 3: Several days = 1 More than half the days = 2 Nearly every day = 3 3. Add together column scores to get a TOTAL score. 4. Refer to the accompanying PHQ-9 Scoring Box to interpret the TOTAL score. 5. Results may be included in patient files to assist you in setting up a treatment goal, determining degree of

    • [PDF File]COLUMBIA-SUICIDE SEVERITY RATING SCALE (C-SSRS)

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      establish a person’s immediate risk of suicide and is used in acute care settings. In order to make the C-SSRS Risk Assessment available to all Lifeline centers, the Lifeline collaborated with Kelly Posner, Ph.D., Director at the Center for Suicide Risk Assessment at Columbia

    • [PDF File]Standard Form 86 - Questionnaire for National Security

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      When entering a U.S. address or location, select the state or territory from the "States" dropdown list that will be provided. For locations outside of the U.S. and its territories, select the country in the "Country" dropdown list and leave the "State" field blank. 4. QUESTIONNAIRE FOR NATIONAL SECURITY POSITIONS. Standard Form 86

    • [PDF File]NICHQ Vanderbilt Assessment Scale—PARENT Informant

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      To day’s Date: _____ Child’s Name: _____ Grade Level: _____ Directions: Each rating should be considered in the context of what is appropriate for the age of the child you are rating and should reflect that child’s behavior since the beginning of the school year.

    • [PDF File](Do not write in this space) APPLICATION FOR DISABILITY ...

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      APPLICATION FOR DISABILITY INSURANCE BENEFITS. Page 1 of 7 OMB No. 0960-0618. I apply for a period of disability and/or all insurance benefits for which I am eligible under Title II and Part A of Title XVIII of the Social Security Act, as presently amended. (Do not write in this space) 1. PRINT your name. FIRST NAME, MIDDLE INITIAL, LAST NAME 2.

    • [PDF File]IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM HEALTH CARE ...

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      and which, due to his/her physical or mental condition, are necessary to maintain his/her health). The IHSS program provides hands-on and/or verbal assistance (reminding or prompting) for the services listed above. STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM HEALTH CARE CERTIFICATION FORM

    • [PDF File]MEDICAL REQUEST FOR HOME CARE HCSP- M11Q 12/09/2014 GSS ...

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      I also understand that this physician’s order is subject to the New York State Department of Health regulations at part 515, 516, 517, and 518 of title 18 NYCRR, which permit the department to impose monetary penalties on, or sanction and recover ... * Please provide this sheet to the physician filling out the Medical Request for Home Care (M ...

    • [PDF File]Form W-9 (Rev. October 2018)

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      U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership

    • [PDF File]Statement of Claimant or Other Person - The United States ...

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      STATEMENT OF CLAIMANT OR OTHER PERSON. Form Approved OMB No. 0960-0045 Name of Wage Earner, Self-employed Person, or SSI Claimant ... day, year) Telephone Number (Include Area Code ) ... To make determinations for eligibility in similar health and income maintenance programs at the Federal, State, and

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