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Get the free REFERRAL TO BEHAVIORAL HEALTH SERVICES - ncdhhs

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This document serves as a referral for a patient requiring a Behavioral Health Assessment from a primary care provider.
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How to fill out referral to behavioral health

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How to fill out REFERRAL TO BEHAVIORAL HEALTH SERVICES

01
Obtain the referral form from your healthcare provider or the relevant department.
02
Fill in the patient's personal information, including their name, date of birth, and contact details.
03
Specify the reason for the referral, detailing any specific behavioral health concerns.
04
Indicate the preferred behavioral health services or specialists, if applicable.
05
Include any relevant medical history or previous treatments related to behavioral health.
06
Sign and date the form to validate your referral.
07
Submit the completed referral form to the appropriate behavioral health services provider.

Who needs REFERRAL TO BEHAVIORAL HEALTH SERVICES?

01
Individuals experiencing mental health issues such as anxiety, depression, or other mood disorders.
02
People dealing with substance abuse or addiction problems.
03
Patients requiring support for behavioral issues, including eating disorders or ADHD.
04
Anyone facing emotional or psychological distress affecting their daily functioning.
05
Individuals seeking therapy or counseling for personal development or coping strategies.
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During your intake appointment, a behavioral health professional will listen to your story and explore your medical history, symptoms, and therapy goals. By understanding your emotional, physical, and psychological well-being, we'll recommend the best treatment path for you.
The Core Elements of a Referral Letter #1. Information about the patient. #2. The main complaint. #3. Anamnesis of the disease. #4. Client's personal history. #5. Mental state examination and evaluation. #6. Drug or medical history. #7. Preliminary diagnosis and planning.
Some mental health problems require immediate attention and referral to a specialist or admission to the hospital (e.g., an eating disorder with direct risk for the person, or acute suicide risk).
Say, ``has a mental illness.'' It can also be appropriate to say ``mental health condition,'' since many people who deal with mental health concerns may not have a formal diagnosis or a full-fledged illness.
If you feel like you could be a danger to yourself or others. If you're losing large increments of memory. If you're hearing voices that aren't there or are seeing things that are not there. If you're suffering with crippling anxiety or paranoia or confusion. If you can no longer find joy in anything.
Behavioral health is an umbrella term that refers to the following topics: Mental health (i.e., well-being, mental distress, mental health conditions) Suicidal thoughts or suicide attempts. Substance use or substance use disorders.
Consider a referral for a more thorough evaluation with a mental health professional if: Traumatic stress reactions are severe or prolonged (more than a month). Traumatic stress reactions interfere with recovery or with returning to normal activities.
Behavioral health is a broad term that includes mental health and behaviors that affect physical health and well-being. It examines how habits, lifestyle choices, and mental health impact overall health. Conversely, mental health focuses on emotional, psychological, and social well-being.

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Referral to Behavioral Health Services is a process by which an individual is directed to professional mental health or substance abuse treatment services based on their assessed needs.
Typically, healthcare providers, social workers, or other professionals involved in patient care are required to file a Referral to Behavioral Health Services when they identify a need for mental health or addiction support.
To fill out a Referral to Behavioral Health Services, one must provide the patient's personal information, details about their mental health or substance use concerns, reason for referral, and any pertinent medical history or previous treatments.
The purpose of the referral is to ensure that individuals receive appropriate mental health or substance use treatment in a timely manner, facilitating access to the necessary support services.
The information that must be reported includes the patient's demographics, the reason for referral, specific issues or symptoms observed, any relevant medical history, and the desired outcomes of the referral.
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