Deceased Client or Employee Report
Instructions: Any employee of the Department of Human Services who becomes aware of the death of a client or an employee shall immediately notify their supervisor or the Office or Division Director. This form should be completed and sent, along with copies when requested of ALL the case files, records, or other documents pertaining to the client, to the Office or Division Director within three (3) days of knowledge of the death. The Office or Division Director shall immediately forward all information to the Department Director and the Fatality Review Coordinator.
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