DHS Client Referral 

Client Information
Client Contact Information










Additional Collection Site Information 
Different Address




Different County 




XXX - XX -

Agency & Case Information




Courtesy Case Information




Caseworker Information





Secondary Caseworker





Screen Information

What is Random Ongoing Testing? 

When you choose Random Ongoing Testing, you are selecting for your client to participate in the call in program and have a random schedule generated. You must select the amount of screens you would like per a duration (7 day period, 30 day period, or year period) and beginning/end screening dates. 

What is One Time Screening ? 

When you select ‘One Time Screening’ you are choosing for your client to have 1 test at a date you decide. You must enter a beginning screening date. 

What is Non Call in Ongoing Testing?

When you select ‘Non Call In Ongoing Testing’ you are choosing for your client to have ongoing testing on dates of your deciding with no Call In feature. You must enter a beginning screening date. 






     
 screens per 


Example
For instance, if you would like 3 screens every week, enter the information in the following way: 





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