Get the free Targeted Case Management Referral Form - intranet spbh

SUTTON PLACE BEHAVIORAL HEALTH Targeted Case Management Referral Form Client Name: Date of Referral CID# Guardian (if applicable) Age/DOB SSN# Address Phone# Medicaid: Yes No # Person completing referral

How to fill out targeted case management referral

How to fill out targeted case management referral:

1. Obtain the referral form: Contact the appropriate agency or organization that provides targeted case management services and request a referral form. This form may be available online or through physical copies.
2. Gather necessary information: Collect all relevant information about the individual who needs the targeted case management services. This may include their personal details, medical history, current needs, and any other pertinent information.
3. Complete the referral form: Fill out the referral form accurately and thoroughly. Provide all required information, ensuring that it is legible and easy to understand. Double-check for any errors or missing information before submitting the form.
4. Include supporting documentation: Attach any supporting documentation that may strengthen the referral. This can include medical reports, assessments, or any other documents that provide a comprehensive overview of the individual's needs.
5. Obtain necessary signatures: If required, make sure to obtain the necessary signatures of the person making the referral and the individual who needs targeted case management services. This helps to ensure that all parties are aware and agree to the referral.
6. Submit the referral: Once the referral form is completed and all supporting documentation is attached, submit it to the designated agency or organization responsible for processing targeted case management referrals. Follow their submission instructions and deadlines to ensure a timely processing of the referral.

Who needs targeted case management referral?

1. Individuals with complex needs: Targeted case management referrals are typically made for individuals who have complex needs that require assistance from various service providers. This includes individuals with physical or mental health conditions, developmental disabilities, or substance abuse issues.
2. Individuals in need of comprehensive support: Targeted case management referrals are beneficial for individuals who require comprehensive support to navigate various systems or services. This can include assistance with accessing healthcare, housing, education, employment, counseling, and other essential resources.
3. Individuals requiring advocacy and coordination: Those who require advocacy and coordination between different service providers may also benefit from targeted case management referrals. This ensures that the individual receives the necessary support, resources, and interventions to address their specific needs.

In summary, filling out a targeted case management referral involves obtaining the referral form, gathering necessary information, completing the form accurately, including supporting documentation, obtaining necessary signatures, and submitting the referral to the appropriate agency. This referral is typically made for individuals with complex needs, requiring comprehensive support, advocacy, and coordination between various service providers.

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What is targeted case management referral?

Targeted case management referral is a process where individuals are referred to services and resources to address their specific needs.

Who is required to file targeted case management referral?

Healthcare professionals, social workers, and case managers are typically required to file targeted case management referrals.

How to fill out targeted case management referral?

Targeted case management referrals can be filled out by providing detailed information about the individual's needs and the specific services they require.

What is the purpose of targeted case management referral?

The purpose of targeted case management referral is to connect individuals with the appropriate resources and services to address their specific needs.

What information must be reported on targeted case management referral?

Information such as the individual's demographics, medical history, current needs, and the recommended services must be reported on targeted case management referral.