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CODEDESCRIPTIONFULL CODEPER2660 DAY EMPLOYEE FEEDBACK TOOLPER/26-914SR1406ACCOUNTING FOR DISCLOSURESSR/1406-1003PER40-1ACKNOWLEDGEMENT OF RULE 1PER/40.1-497SO941ACTIVE LEISURE PARTICIPATIONSO/941-706PER40.8ADL/IADL COMPETENCY ASSESSMENTPER/40.8-215SO944ACTIVITY LOGGINGSSO/944-505PER8AD REQUESTPER/8-610SR1508ADAPTIVE EQUIPMENT MONITORING TOOLSR/1508-707CM1021ADMINISTRATIVE REVIEW FOR CHILD IN PLCMNTCM/1021-1297ICF102ADMISSION COMMITTEE PLACEMENT DECISIONICF/102-0290CM106-1ADMISSION, DISCHARGE AND STATUS CHANGE CM/106.1-414 CM106-2ADMISSION, DISCHARGE AND STATUS CHANGE (CARE COORDINATION)CM/106.2-615 PER63AFFIRMATIVE ACTION DATA INPUT SHEETPER/63-1098 PER10AFFIRMATIVE ACTION QUESTIONNAIREPER10-514ICF105.2AGREEMENT TO PROVIDE CONSULTANT DIETITAN SERVICESICF/105.2-0190ICF105.1AGREEMENT TO PROVIDE DENTAL SERVICESICF/105.1-0190ICF105.14AGREEMENT TO PROVIDE GENERAL MEDICAL SERVICESICF/105.14-0190ICF105.13AGREEMENT TO PROVIDE NEUROLOGICAL SERVICESICF/105.13-0290ICF105.5AGREEMENT TO PROVIDE OPTHAMOLOGY/ OPTOMETRY SERVICESICF/105.5-0990ICF105.7AGREEMENT TO PROVIDE PHYSICAL THERAPY SERVICESICF/105.7-0190ICF105.6AGREEMENT TO PROVIDE PODIATRIST SERVICESICF/105.6-0190ICF105.12AGREEMENT TO PROVIDE PSYCHIATRIC SERVICESICF/105.12-0290ICF105.9AGREEMENT TO PROVIDE PSYCHOLOGICAL SERVICESICF/105.9-0190SR105.3AGREEMENT TO PROVIDE SERVICESSR/105.3-611ICF105.10AGREEMENT TO PROVIDE SPEECH PATHOLOGY AND LANGUAGE SERVICESICF/105.10-0190ICF105.11AGREEMENT TO PROVIDE THERAPY SERVICESICF/105.11-0290SO1305ALCOHOLIC BEVERAGE CONSENT FORMSO/1305-107CONS451-1ANNUAL ACCOUNT – DAKOTA COUNTYCONS/451.1-0105SO454ANNUAL CHECKLIST AND FLOWCHART CSSP ADDENDUM/ANNUAL MEETINGSO/454-1214CONS441.1ANNUAL INFORMATIONAL STATEMENTCONS/441.1-810ICF1010.2ANNUAL SUMMARY OF SKILLS AND NEEDS (ICF/MR ONLY)ICF/1010.2-706CM1463ANOKA COUNTY DATA REQUEST FORMCM/1463-1299 CM505ANOKA COUNTY SOCIAL WELFARE FUND DISBURSEMENT PLANCM/505-1201 PER10APPLICATION QUESTIONNAIREPER/10-708SO1586ARCHIVE REQUESTSO/1586-1005HEN220ASSESSMENT INFORMATION CHECKLISTHEN/220-706SO954ASSESSMENT OF CLIENT INTERESTSSO/954-408PER87ASSESSMENT OF PROPER LIFTING/TRANSFERRING TECHNIQUESPER87-714SR201ASSESSMENT OF STAFF HOYER LIFT TRANSFER TECHNIQUESSR/201-714SR250ASSESSMENT OF STAFF TRANSFER TECHNIQUES USING AN EZ/LIFT-U-UP/GET-U-UP DEVICESR/250-215SR202ASSESSMENT OF STAFF – VAN LIFT OPERATIONS & WHEELCHAIR SECUREMENT TECHNIQUES VAN - SEE ALSO - SAFETY TEST OUT USING Q’STRAINTS (SR1350)SR/202-1114SR1350ASSESSMENT OF VAN LIFT OPERATION AND WHEELCHAIR SECURMENT USING Q’STRAINTS – SEE ALSO - ASSESSMENT OF STAFF – VAN LIFT OPERATIONS & WHEELCHAIR SECUREMENT TECHNIQUES VAN (SR202)SR/1350-1114SR220.1ASSESSMENT SUMMARY – GUIDELINES FOR COMPLETIONSR/220.1-114ICF205.1ATTACHMENT A – PROCEDURES FOR CONTINUED STAY REVIEWICF/205.1-0190OAK205.2ATTACHMENT B MEMBERS OF UTILIZATION REVIEW COMMITTEEOAK/205.2-308 ICF205.3ATTACHMENT C – CONTINUOUS STAY REVIEW CHECKLISTICF/205.3-1290ICF205.4ATTACHMENT D UTILIZATION REVIEW COMMITTEE MINUTESICF/205.4-1000 ICF205.5ATTACHMENT E – LIST OF CASES APPROVED FOR CONTINUED STAYICF/205.5-0190ICF205.6ATTACHMENT FICF/205.6-0190ICF205.7ATTACHMENT G – CONTRACT FOR UTILIZATION REVIEW SERVICEICF/205.7-1090ICF205.8ATTACHMENT H – LEVEL OF CARE CRITERIAICF/205.8-0191ICF205.9ATTACHMENT I – CONTRACT FOR PHYSICIAN UTILIZATION REVIEW SERVICEICF/205.9-0390PER66ATTENDANCE HISTORYPER/66-1100 SO1470AUDIT SCHEDULE 2015SO/1470-215 SR403.1AUTHORIZATIONSR/403.1-403CM403.2AUTHORIZATION FOR THE RELEASE OF INFORMATIONCM/403.2-1112CM403.3AUTHORIZATION FOR THE RELEASE OF INFORMATIONCM/403.3-613SR506AUTHORIZATION TO ASSIST WITH FINANCESSR/506-315 SILS1460AUTHORIZATION TO WORK AT HOME SILS/1460-802 JS848AWAKE NIGHT COUNSELOR TASKSJS/848-1102 PER20.5BACKGROUND STUDY FORMPER/20.5-1112PER20.6BACKGROUND STUDY FORM (INTELLICORP)PER/20.6-1111SO644BASELINE LOGGINGSSO/644-1199 SO315BASELINE ON GAS STOVE SAFETY SKILLSSO/315-0691SR618BASELINE PLANSR/618-1197SR301BEDROOM FURNISHINGSSR/301-115SR1005.10BEHAVIOR INTERVENTION REPORTING FORMSR/1005.10-114SR1005.11BEHAVIOR INTERVENTION REPORT FORM INSTRUCTIONSSR/1005.11-114SO641.2BEHAVIOR OBSERVATION SYSTEM – CLIENT DATA SHEETSO/641.2-0190SO642.09BEHAVIOR RECORDING – ? 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