Submission Instructions for Emergency/STAT Medications

Confirms who is submitting the form whether it is the provider’s office, faculty/staff from a secondary institution, or from somewhere else like the caseworkers office. First name, last name, email, and phone number of the submitter are required. Providing an extension is not required but allows the processor to reach the person with the necessary information more quickly. It’s a good idea to put your preferred fax number in if you want to indicate where you want the consent sent.

The first name, last name, DOB, placement type, and name of placement are required. If available, please include the youth’s DCFS ID. ID must be 8 characters and cannot end in 00.

The first name, last name, specialty, and phone number are required information in case we need to reach out with questions.  Always only add ATTENDING physicians and FELLOWS to the consent, never Residents.

*If provider has never submitted a consent to DCFS before, adding an NPI number in the “Other” box helps us add the new provider to our system without needing a call.

You are first asked for the request type. Indicate if the request is for a one-time emergency medication notification, select “Yes.” The rest of the boxes on the page will disappear and you can go on to the next page.

Is the Youth currently on Psychotropic Medication? Select ‘No’ if this request is for a one-time emergency medication; this allows you to move to the next page without listing current medications.

1. Below the type of request, you are asked to indicate if youth is taking the medication without consent. Select “No.”
2. The medication name is required.
3. The medication form is required. If you choose “Solution”, you will be asked to provide the concentration of the solution.
4. Medication dosage: Enter the dosage in mg.
5. Provide the date and time given of the emergency medication. *Be sure to add a space between the numerical time (1:51) and the 12-hour designation (am and pm) or you will get a formatting error message (i.e. 01/01/2025 08:15 AM)
6. List the symptoms prompting the administration of the medication.
7. Once everything is entered, click “Submit” and the medication information will be displayed in the table.
   • Add as many emergency medications as needed if multiple emergency medications were given at the same time or at a different time or date.
8. Disregard the request for lab work for emergency medications.

You are asked to confirm if the medications have been reviewed with the youth and whether the youth objects to the medication. The third box asks if there is any additional information relevant to the request that has not been captured elsewhere. Upload any attachments at the bottom of the page under ‘Attachments.’

The last page requests a CAPTCHA prompt be entered to prove you are human before allowing submission of the consent request.

A copy of the completed CFS 431-A form will be sent to the email you provided on page 1 for your records and as confirmation of your submission.