10A NCAC 28F .0205 WRITTEN EVALUATION BY AREA PROGRAM
(a) Area program staff shall evaluate each individual prior to authorization and referral to the hospital unless G.S. 122C‑262 applies.
(b) The evaluation shall be in writing and shall include the following:
(1) identifying information, e.g., client's full name (including maiden name), address, birthdate, race;
(2) referral source;
(3) presenting problem;
(4) if available, medications and pertinent medical and psychiatric information, including the DSM‑IV diagnoses, history of treatment, side effects, allergies, last injection date, recent laboratory work;
(5) name, address and phone number of legally responsible person and next of kin, if applicable;
(6) legal charges pending, if applicable; and
(7) name and telephone number of the area program staff members to contact for further information including staff to call after regular working hours.
(c) The evaluation shall accompany the individual to the hospital.
History Note: Authority G.S. 122C‑53(a); 122C‑55(a); 143B‑147;
Eff. February 1, 1989;
Amended Eff. July 1, 1996; March 1, 1990.