Embedded Files
On this module, you will find the OTP HH Eligibility and Follow-Up Checklist, along with the OTP HH Receive/Resume Services form. They are also provided in the Spanish translation.
OTP Health Home Eligibility and Follow-Final.docxOTP Health Home Eligibility and Follow-up Checklist
OTP HH Receive or Resume Form - Final.docxOTP HH Receive/Resume Services
OTP Health Home Eligibility and Follow-Final (Spanish) Approved.docx(Spanish) OTP Health Home Eligibility and Follow-up Checklist
OTP HH Receive or Resume Form - Final (Spanish) Approved.docx(Spanish) OTP HH Receive/Resume Services
The OTP HH Eligibility & Follow-Up Checklist must be completed at the time of admission for new patients entering the program; at admission to Health Home program for current patients; and annually at each physical appointment. All forms/documentation should be noted in the patient's chart and continually kept up to date.
Survey Instrument revised.docxHH Patient Satisfaction Survey (English)
HH Patient Satisfaction Survey (English)
Survey Instrument (Spanish) 2024 final.docxHH Patient Satisfaction Survey (Spanish)
HH Patient Satisfaction Survey (Spanish)
On an annual basis, the OTP Health Home Program participates in the dissemination of a patient satisfaction survey. This is typically completed annually in the month of November. Staff are suggested to use any of the following approaches when distributing the survey to patients:
Administer the survey during the last 5 minutes of group or individual counseling, and ask that they place the survey in a box upon leaving the room (a box designated specifically for surveys).
Provide the survey along with an envelope and ask patient to complete while waiting for an appointment, and return it to the counselor and/or administrative assistant.
Ask patient to complete it as part of their annual physical exam.
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