These are commonly used clinical documents. We refer to them as sets because the documents in a particular set work together. For example, rather than typing in the same information from one document to the next, these are automated for you using a feature called dataflow. These sets are free to all product and RCM customers.
What is in a Form Set?
A form set typically includes an assessment, treatment plan, progress note and a discharge summary.
Commonly Used Sets
Mental Health
- PRO-0124 MH Client Intake Questionnaire
- PRO-1109 MH Diagnostic Assessment
- PRO-1113 Alternate Diagnostic Assessment
- PRO-1202 MH Treatment Plan
- PRO-1307 MH Progress/Case Note
- PRO-1308 MH Group Progress Note
- PRO-1404 MH Discharge Summary
Substance Use 245G - Simple Version
- PRO-245G-1100S Comprehensive Assessment (245GS)
- PRO-245G-1101S Comprehensive Assessment Summary (245GS)
- PRO-245G-1200S Individual Treatment Plan (245GS)
- PRO-245G-1300S Documentation of Treatment Services/Treatment Plan Review (245GS)
- PRO-245G-1301245G Simple Progress Note
- PRO-245G-1400S Service Discharge Summary (245GS)
- PRO-245G-1000 Initial Services Plan and Vulnerable Adult Determination (245G)
NOTE: The above set was designed using this MN DHS documentation: Requirements for 245G Clinical Documents
Substance Use 245G - Expanded Version
- PRO-245G-1000 ISP and VA Determination
- PRO-245G-1001 Intake - Client Information
- PRO-245G-1002 Intake - Substance Use
- PRO-245G-1003 Intake - Physical and Mental Health
- PRO-245G-1004 Intake - Legal, Education and Vocation
- PRO-245G-EP1100 245G Comprehensive Assessment and Summary
- PRO-245G-EP1101 245G Comprehensive Assessment Summary
- PRO-245G-EP1140 DAANES Client Admission 245G
- PRO-0122 DAANES Service Initiation
- PRO-245G-EP1200 245G Treatment Plan
- PRO-245G-1201 Individual Recovery Plan
- PRO-245G-EP1300 245G Progress Note/Treatment Plan Review
- PRO-245G-1302 Individual Progress Note (245G)
- PRO-245G-1303 Group Progress Note (245G)
- PRO-245G-1304 Peer Recovery Support Services
- PRO-245G-1305 Treatment Coordination Services
- PRO-245G-EP1336 DAANES 6 Month Review 245G
- PRO-245G-EP1400 245G Discharge Summary
- PRO-245G-EP1440 DAANES Discharge 245G
ARMHS
- PRO-1115 ARMHS Functional Assessment
- PRO-1214 ARMHS Crisis Plan
- PRO-1213 ARMHS ITP
- PRO-1315 ARMHS Group Note
- PRO-1312 ARMHS Interpretive Summary
- PRO-1313 ARMHS Progress Note
- PRO-1314 Collateral Note
- PRO-1406 ARMHS Discharge Summary
CTSS
- PRO-1114 CTSS Diagnostic Assessment
- PRO-1212 CTSS Treatment Plan
- PRO-1311 CTSS Progress Note
- PRO-1405 CTSS Discharge Summary
EIDBI
- PRO-1162 CMDE Medical Necessity Summary Information (DHS-7108-ENG)
- PRO-1236 EIDBI ITP and Progress Monitoring (DHS-7109-ENG 8-19)
- PRO-1353 Autism Therapy Progress Note
- PRO-1354 Autism Skill Progress Note
- PRO-1355 EIDBI Progress Note
- PRO-1408 EIDBI Discharge Summary
- PRO-1453 EIDBI Transition and/or Discharge Summary
- PRO-0077 EIDBI Client Rights and Responsibilities
- PRO-0078 EIDBI Provider Agency Responsibilities
Housing
- PRO-HS-1616 Combined Application Form
- PRO-HS-1570 SSI Interim Assistance Authorization DHS-1795-ENG
- PRO-HS-1574 Interim Assistance Agreement (Do not use for SSI) DHS-1795A-ENG
- PRO-HS-1613 Professional Statement of Need DHS-7122-ENG
- PRO-HS-1568 MH DHS Habitability Inspection Form (DHS-7123-ENG)
- PRO-HS-1617 Authorization for Release of Information About Residence and Shelter Expenses DHS-2952-ENG
- PRO-HS-1608 Signed Personal Statement about Assets for Cash Programs
- PRO-HS-1001 Long-Term Homelessness Eligibility Form
- PRO-HS-1002 MN Housing Third Party Verification Form
- PRO-HS-1003 Housing Services Intake Form
- PRO-HS-1005 Crisis Plan
- PRO-HS-1302 Housing Supervision Note
- PRO-HS-1004 Housing Toolkit
- PRO-HS-1007 Housing Focused Person-Centered Plan DHS-7307-ENG
- PRO-HS-1615 Housing Stabilization Services End DHS-8110-ENG
- PRO-HS-1100 Housing Services Assessment
- PRO-HS-1200 Housing Services Support Plan
- PRO-HS-1300 Housing Services Activity Based Case Note
- PRO-HS-1301 Housing Services IRP Case Note
- PRO-HS-1303 Housing Services Recipient Verification
- PRO-HS-1400 Discharge Summary
245F Withdrawal Management
- PRO-245G-EP1100 245G Comprehensive Assessment
- PRO-1548 DHS-Individual Abuse Prevention Plan (IAPP)
- PRO-245F-1200 Stabilization Plan
- PRO-245F-1300 Progress Note
- PRO-245F-1400 Discharge Plan