Substitute Forms

OKLAHOMA DEPARTMENT OF HUMAN SERVICES

Developmental Disabilities Services Division

Sequoyah Memorial Office Building

PO Box 25352

Oklahoma City, OK 73125-9907

PH: (405) 521-3571  FX: (405) 522-3037  www.okdhs.org

Administrative Letter 19-13

June 17, 2019

Dear Provider,

Developmental Disabilities Services (DDS) has a review process that allows provider agencies to submit a form for review and approval to use in lieu of a DDS official form. Since we recently updated the DDS-5 Referral Form for Examination and Treatment and the DDS-73 Referral Form for Psychiatric Treatment or Examination, providers who would like to continue using their own agency forms should submit those forms for approval.

The documents listed below were previously approved:

• Therap Consultation Form substituting for 06HM005E, DDS-5 Referral Form for Examination or Treatment.

• QuickMAR Referral form Examination and Treatment substituting for 06HM005E, DDS-5 Referral Form for Examination or Treatment.

• QuickMAR Referral form Psychiatric Treatment or Examination substituting for 06HM073E, DDS-73 Referral Form for Psychiatric Treatment or Examination.
  
  By September 1, 2019, providers will need to begin using the DDS revised official forms or submit their proposed substitute forms to DDS for approval. Substitute forms must be compliant with related policy and include all critical elements of the official DDS form designated for substitution.
  
  You may direct questions about this project to Darrin Thompson at darrin.thompson@okdhs.org or Sheila Bowen at sheila.bowen@okdhs.org.
  
  Sincerely,
  
  Beth Scrutchins, Director
  
  Developmental Disabilities Services