SOP_NUMBER: 508.15-att-5
TITLE: Requested Records Log
DIVISION: Mental Health Services
TOPIC_AREA: 508 Policy-MH Evaluations/Screenings/Treatment
EFFECTIVE_DATE: 2022-08-15
WORD_COUNT: 56
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/353021
URL: https://gps.press/sop-data/508.15-att-5/

SUMMARY:
This is a tracking form used by mental health staff to document and manage requests for offender records from other facilities or locations. The form records offender identifying information, where records were requested from, dates of request and receipt, and any follow-up actions needed. Completed forms must be retained in the mental health area for four years.

KEY_TOPICS: records request, mental health records, offender information, tracking log, records management, inter-facility requests, follow-up actions, GDC number, mental health documentation

ATTACHMENTS:
  1. Mental Health Evaluation for Services (Form M31-01-01)
     URL: https://gps.press/sop-data/508.15-att-1/
  2. Mental Status Evaluation (Attachment 2)
     URL: https://gps.press/sop-data/508.15-att-2/
  3. Authorization for Release of Information (Mental Health Services)
     URL: https://gps.press/sop-data/508.15-att-3/
  4. Parole Evaluation Log (Form M31-01-04)
     URL: https://gps.press/sop-data/508.15-att-4/
  5. Requested Records Log
     URL: https://gps.press/sop-data/508.15-att-5/

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FULL TEXT:
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# **Requested Records Log**

Facility: ____________________________________________









SOP 508.15
Attachment 5

8/15/22


|Offender Name|GDC #|Social Security #|Location Records<br>Requested From|Date Request<br>Mailed/Faxed|Date Records<br>Received|Follow-Up Actions|Col8|
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Form no. M31-01-05                                                         Page 1 of 1

Retention Schedule: Completed forms shall be maintained in the mental health area for four (4) years, then destroyed or archived.