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Form Details
- Form Properties
- Form Title: Phase 2 Psychopharmacology Plan
- Start from an Existing Form – Yes, if there is a previous version signed and locked.
- Copyrighted Form – No
- Billable Progress Note – No
- Have multiple versions open at same time – No
- Open Blank on new version – No
- Required Fields – Yes
- Lookup Tables – None
- Pre-Fill Logic – Yes
- Organization Name will prefill from Setup → Program/Billing Defaults → Company Info Tab.
- Program Name will prefill from the Program the patient is enrolled in.
- Identified needs will prefill from the most recent completed Assessment.
- Fill to Logic – None
- Signatures
- Individual Served Signature
- Sig type: Patient
- Parent/Guardian Signature
- Sig type: None
- NPP Signature
- Sig type: NPP
- N/A defaults to unchecked.
- Route to function available.
- Signature locks form.
- Psychiatrist/MD/DO Signature
- Sig type: Physician, Psychiatrist, DO, MD
- N/A defaults to unchecked.
- Route to function available.
- Signature locks form.
- Staff Signatures (2)
- Sig type: Any
- N/A defaults to unchecked.
- Route to function.
- Signature locks form.
- Individual Served Signature
Patient Info Tab
- Indicate Organization, Program, and Plan initiation and target completion dates (required).
- Add additional information as desired.
Goals and Objectives Tab
- Indicate Strengths & Skills and not Outside Services (required).
Intervention Methods Tab
- Indicate therapeutic intervention methods.
Referrals Tab
- Note any referrals and/or additional evaluations (required).
- Indicate if explanation noted has been provided (required).
- Indicate if the individual or others have participated in plan development (required).
Signatures Tab
- Signatures Credentials (see eCR University - Credentials)
- Individual Served Signature
- Sig type: Patient
- Parent/Guardian Signature
- Sig type: None
- NPP Signature
- Sig type: NPP
- N/A defaults to unchecked.
- Route to function available.
- Signature locks form.
- Psychiatrist/MD/DO Signature
- Sig type: Physician, Psychiatrist, DO, MD
- N/A defaults to unchecked.
- Route to function available.
- Signature locks form.
- Staff Signatures (2)
- Sig type: Any
- N/A defaults to unchecked.
- Route to function.
- Signature locks form.
- Individual Served Signature