Intake Tab

SCREENING

INTAKE TAB

Document information in all the required fields in this section.

Presenting Problem(This is a required field for Mental Health and Substance Abuse Services)

• This field is used to record the primary concern that has brought the client to the provider. Use the client’s own words when possible. The Presenting Problem should be brief.
• The information you enter into Presenting Problem will auto-fill to the Presenting Problem field in the Assessment document when an assessment is documented on the client.

How to enter a 'Presenting Problem'.

1. Move your mouse into the text box next to 'Presenting Problem' and CLICK INSIDE the text-box.

2. TYPE IN the client’s presenting problem, using his/her own words as much as possible.

EXAMPLE 1: I am sick of my life. I spend all my time thinking about how I can get my next fix. I have nothing, I am nothing and I can’t take it any more. I’ve tried to do it on my own but I need help to do this.

EXAMPLE 2: I have been so depressed since my baby’s death that I don’t care about anything anymore. I’m so tired and sick I can’t get out of bed before noon. All I think about is dying to be with my little girl.

EXAMPLE 3: Why am I here? I don’t Goddamned know why I am here. I’m here because God made me come here. Led me here to show me the evil in the world. To show me what will happen if the savior doesn’t return soon. I might be the savior.

Screening Method

(This is a required field for Mental Health and Substance Abuse Services)

This field is used to record the screening method used to obtain information from the client. Choose one option from the Screening Method drop down list. Only one answer can be selected.

• Clinician may have used more than one method; however, a determination must be made as to the method that is most representative of how the information was collected from the client.

1. Move your mouse to the drop down button in the box next to' Screening Method'.
2. A drop down box will appear to allow you to select the type of screening method you are using.
3. Select the 'Screening Method' using the drop down box.
4. CLICK ON the arrow to see the answer choices.
5. CLICK ON the client’s answer to select it.
6. You may only select one answer.

CLICK HERE for the Screening Methods.

Screening Method	Screening Method Description
Face-to-Face	All or most of the screening interview was conducted in person
Telephone	All or most of the screening interview was conducted by telephone.
Telehealth	All or most of the screening interview was conducted by audio/visual teleconferencing with the client.

To view an example of how to select a Screening Method CLICK ON the links below.

 

EXAMPLE 1: The Clinician met with the prospective client’s parents in person and they provided some information about their daughter’s condition. The Screener later spoke with the client by phone. The screening was conducted during a 20-minute conversation with the client by phone. The Clinician selected Telephone because that is how the contact with the client took place and how the information from the client condition was collected. The face-to-face collateral contact provided the screener some initial information but was not the screening.

 

Example 2: The Clinician received a call from the client who had just been discharged from the provider’s Intensive Outpatient Substance Abuse Program 3 weeks ago. The client told the clinician that he had relapsed, described the problems he was having and said he really wanted to get back into treatment. The Clinician indicated that he had an opening and the client came in later that after-noon and was screened. The Clinician selected Face to Face even though the initial contact was by phone.

 

Interview Setting(This is a required field for Mental Health and Substance Abuse Services)

This field is used to document the setting where the screening interview occurred.

1. Select the Interview Setting that best describes where the Intake interview took place using the drop down box
2. If the screening occurred in more than one setting, you must determine the setting where the majority of the interview took place and select only one answer.
3. CLICK ON the arrow to see the choices.
4. CLICK ON the answer to select it.
5. CLICK HERE

Note:

If the screening occurred in more than one setting, you must determine the setting where the majority of the interview took place and select that setting only.

Referred by

(This is a required field for Mental Health and Substance Abuse Services)

This field is used to document the person, agency or legal entity that referred the individual to the provider for services.

1. Use this field to indicate the primary referral source for this client for this episode of care.
2. If more than one entity was involved in referring the client, determine which referral entity played a primary role and indicate that as your answer.
3. CLICK ON Referred By to review all the answer choices.
4. Then use the slide bar to the right of the drop down menu to SCROLL through the choices.
5. Select the answer choice that best describes who referred the client for services by CLICKING ON it.
6. Choose one referral source from the drop down list.
7. CLICK HERE to see the "Referred by List"

Screening Date

(This is a required field for Mental Health and Substance Abuse Services)

This field is used to document the date that the client screening occurred. It will display today's date.

• If today is the date the screening occurred, it automatically will display in this field and you do not need to do anything. Go to the next step.
• If the screening occurred some day other than today, you must enter the correct date.
• The date you enter must be a past date as you may not enter a future date.
• CLICK IN the Screening Date box to enter the date the screening occurred.
• Enter the date in the text box by TYPING IN 8 numbers (mmddyyyy) and CMBHS will put them on the correct date format (mm/dd/yyyy) or you can TYPE the numbers and slash marks into the text box. (mm/dd/yyyy).

What’s Next?

• If you are screening a client for mental health services, CLICK Mental Health Questions tab.
• If you are screening a client for substance abuse services, CLICK Substance Abuse Questions tab.

CLICK HERE to Return to 'Document A Screening'

NEXT SCREENING, MENTAL HEALTH TAB