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NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

08-22-2007

Subchapter:

1

Forms

Issuance:

11.63

CP&P Form 11-63, Request for CHEC Visit

 

 

Click to view or print the CP&P Form 11-63, Request for CHEC Visit.

 

WHEN TO USE IT

 

The purpose of a Comprehensive Health Evaluation for Children-CHEC is to deliver comprehensive health evaluation services to children within 30 days of initial out-of-home placement.

 

HOW TO USE IT

 

·         Access it through the NJ Spirit Desktop > Create > Case Work > Medical/Mental Health > Medical/Mental Health Profile > Medical Profile Tab > Options Drop-down.

·         Only complete this template outside of the NJ Spirit application as part of a contingency plan when the application is unavailable.  However, in doing so, you are still required to create the form in NJ Spirit when the application becomes available.

·         The CP&P Worker completes and submits the CP&P Form 11-63 to the appropriate CHEC site, and schedules the appointment to occur within 30 days of the initial placement.

·         Form instructions are also available through the NJ Spirit Desktop.

TIPS FOR COMPLETING THE FORM

 

This form pre-fills a significant amount of information.  Complete the form and make sure the form has the most current information.

 

DISTRIBUTION

 

Original

-

CHEC site provider

Copy

-

CP&P case record