CFS 415: Ordinary and Routine Medical and Dental Care
Please read the instructions below prior to completing the request. Failure to follow instructions may result in a processing delay.
Instructions:
Only submit a request for consent for a current provider(s). Do not submit a request for emergency rooms, or urgent, immediate or convenient care providers. Do not use acronyms anywhere in the request. If you are submitting a request for HIV testing, please read the DCFS risk factors for HIV testing by clicking HERE. Consent requests must be completed by a provider. If you are a foster parent, please consult with the youth’s caseworker.
Ordinary and Routine medical and dental care includes, but is not limited to:
1. Physical and dental examinations
2. Remedial treatment for minor illnesses
3. Immunizations and related diagnostics laboratory tests, including HIV testing when risk factors are present
This type of request for consent is NOT valid for the following items. Please call the consent unit hotline Monday - Friday from 8:30am-4:30pm at (800) 828-2179. For after hours / state holidays, call (866) 503-0184:
1. Emergency room
2. Urgent care, prompt care, express care, immediate care
3. Walk in clinic
This type of request for consent is NOT valid for the following items. Please complete a CFS 431 request for these categories:
1. Surgery/Procedure
2. Anesthesia (general, local, conscious sedation, nitrous oxide)
3. Blood transfusions
4. Tooth extractions
5. DNA Testing
6. Sleep Study
7. Protective Stabilization
8. Genetic Testing
If you have not received a response to a consent request you previously submitted, DO NOT re-submit the request. Please call the Consent Unit hotline for a status update and have the confirmation number of your previously submitted request available.
