SOP 508.31-att-10: Crisis Stabilization Unit (CSU) Admission Cover Page

Division:
Mental Health Services
Effective Date:
December 9, 2019
Topic Area:
508 Policy - MH Suicide Prevention/ACU/CSU/BTU
PowerDMS:
View on PowerDMS
Length:
93 words

Summary

This is a cover page form used to document the admission and discharge of inmates to the Crisis Stabilization Unit (CSU), a mental health crisis facility within the Georgia Department of Corrections. The form captures basic patient identification information including facility location, offender name, GDC ID number, date of birth, race, and sex. Completed forms are filed in both the offender's medical file and mental health file and retained for 10 years following the end of mental health services or sentence completion.

Key Topics

  • Crisis Stabilization Unit
  • CSU admission
  • mental health crisis
  • inmate mental health
  • crisis intake form
  • admission documentation
  • discharge documentation
  • mental health records
  • offender identification
  • psychiatric hold

Full Text

SOP 508.31
Attachment 10

12/9/19

PATIENT IDENTIFICATION

Facility: ________________________________________

Offender:________________________________________

GDC ID#: _____________________ DOB: ____________

Race: _________________ Sex: ____________________

# CRISIS STABILIZATION UNIT ADMISSION

Date of Admission: _______________________

Date of Discharge: _______________________

Form no. M70-02-10 Page 1 of 1

Retention Schedule: Upon completion, this form shall be placed in the offender’s medical file (Infirmary Section on the top of the CSU packet)
and a copy in the mental health file (section 1). At the end of the offender’s need for mental health services and/or sentence, the mental health file
shall be placed within the offender’s health record and retained for 10 years.

Attachments (9)

  1. CSU_ACU Daily Nursing Clinical Assessment (299 words)
  2. Crisis Stabilization Unit Psychiatric Admission Form (M70-02-02) (218 words)
  3. Abbreviated Psychiatric Admission for CSU (M70-02-03) (105 words)
  4. Crisis Stabilization Unit Treatment Plan (124 words)
  5. Crisis Stabilization Unit Discharge Summary (290 words)
  6. Crisis Stabilization Unit Admission Log (61 words)
  7. CSU Referral Report (M70-02-08) (732 words)
  8. CSU Discharge Summary Note (Form M70-02-09) (130 words)
  9. Crisis Stabilization Unit (CSU) Admission Cover Page (93 words)
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