ER, Hospitalization and Urgent Care Entry Form

***FORM UPDATE FY 25***

Some fields have been removed to shorten the form and streamline data collection.

If there are any questions, please let your IT dept. know. 

Thanks.  

 

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K. Type of Report
N. Person Recommending the Visit
O. Was 911 used?
Q. When was the guardian notified?
R. Is there an Unusual Incident Report associated with this visit?
Z. Disposition from ER/Hospital
Please provide the following information in question "ZE":

1. What led up to the event described above?

2. What was the exact issue that caused the event?

3. What was staff's immediate response to the event?

4a. What testing was done?

4b. What was the results of the testing?

5. What treatment was ordered as a result of the testing?

6. Is there any follow-up needed related to this event?

Please give a brief, specific description that includes all requested information (see instruction above).

ICPN-SST Clinical Therapist/Social Worker/Case Manager 4224R (New Lenox, IL)

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Position:  Clinical Therapist; Social Worker; Case Manager

Locations:  New Lenox, IL

Description: 

ICPN is a team approach, with support and assistance from other team members to provide the highest quality clinical interventions to the people we serve. Position includes full time benefits and competitive pay.  

Responsibilities:

  • Serves as a member of the Illinois Crisis Prevention Network’s Support Service Teams
  • Provide case management and therapeutic supports to children and adults with an intellectual/developmental disability, many of whom are dually diagnosed with a mental illness
  • Individual therapy services
  • Resource development
  • Ensuring family and/or support staff are appropriately trained to effectively implement behavioral and medical recommendations. 

Qualifications:

  • Valid Illinois driver’s license with good driving record and travel within the state of Illinois (required)
  • Bachelor’s degree (required); Master’s degree (preferred)
  • Initial licensure (LPC or LSW) or full licensure (LCPC or LCSW) strongly desired

Contact: Qualified candidates send your resume to Justina Nava at jobs@trinityservices.org

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