Oklahoma Psychiatric Residential Treatment Facility Attestation Form

Form Template

The Oklahoma Psychiatric Residential Treatment Facility Attestation Form mobile app allows you to replace your paper attestation form with an Android, iPhone, tablet or Windows desktop computer.

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Language: English
Country: United States of America

The mobile form includes fields to document items such as provider name, provider ID, address, email and captures the signature of facility director. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your human resources records. You can also use the App Builder to personalize and customize this mobile form. With a reasonable investigation having been conducted in the subject facility, a provider uses the app to attest and comply with all of the requirements governing the use of restraint or seclusion in psychiatric residential treatment facilities providing inpatient psychiatric services to individuals under age 21. This attestation in determining whether the facility is entitled to payment for its services. The user also understands that pursuant to Medicaid regulations has the right to validate that the Provider is in compliance with the requirements, to investigate complaints lodged against the facility, and to investigate serious occurrences.

  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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  • iPhone
  • iPad
  • Android
  • Windows
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  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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