Get the free CHAT-H Referral Form - ochcacom

County of Orange, CA Health Care Agency Public Health Community Nursing REFERRAL FORM CHAT Referral Date: Fax attention to: Becky Stone, SPAN (714) 8347977 Referring Source: Agency Contact Person

How to fill out chat-h referral form

How to fill out a chat-h referral form:

1. Begin by opening the chat-h referral form. You can find this form on the chat-h website or platform.
2. Fill in your personal information, including your full name, contact information, and any relevant identification details such as your employee number or client ID.
3. Next, provide details about the person or organization you are referring. This may include their name, contact information, and any additional information that will help chat-h assess their needs or situation better.
4. Be sure to fill out the referral reason section. Explain why you are referring this person or organization to chat-h. Provide details about their needs, concerns, or any incidents that have occurred.
5. If you have any supporting documents or files that can provide more context or information, make sure to attach them to the referral form.
6. Once you have filled out all the required fields, review the form to ensure all information is accurate and complete.
7. Finally, submit the referral form. You may receive a confirmation message or email to acknowledge the submission.

Who needs a chat-h referral form:

1. Individuals who are in distress or experiencing mental health challenges and could benefit from the services and support provided by chat-h.
2. Anyone concerned for the well-being and mental health of a friend, family member, or colleague may also need to fill out a chat-h referral form.
3. Social workers, healthcare professionals, or community organizations who come across individuals or groups that require mental health assistance can utilize the chat-h referral form to connect them to appropriate resources.

Note: The specific eligibility criteria and guidelines for accessing chat-h services may vary, so it is always advisable to refer to the chat-h website or contact them directly for more detailed information.

For pdfFiller’s FAQs

Where do I find chat-h referral form?

It’s easy with pdfFiller, a comprehensive online solution for professional document management. Access our extensive library of online forms (over 25M fillable forms are available) and locate the chat-h referral form in a matter of seconds. Open it right away and start customizing it using advanced editing features.

How do I fill out chat-h referral form using my mobile device?

You can easily create and fill out legal forms with the help of the pdfFiller mobile app. Complete and sign chat-h referral form and other documents on your mobile device using the application. Visit pdfFiller’s webpage to learn more about the functionalities of the PDF editor.

How do I edit chat-h referral form on an Android device?

You can edit, sign, and distribute chat-h referral form on your mobile device from anywhere using the pdfFiller mobile app for Android; all you need is an internet connection. Download the app and begin streamlining your document workflow from anywhere.

What is chat-h referral form?

The chat-h referral form is a document used to refer a child or adolescent to mental health services.

Who is required to file chat-h referral form?

Any individual or organization that identifies a child or adolescent in need of mental health services is required to file the chat-h referral form.

How to fill out chat-h referral form?

To fill out the chat-h referral form, you need to provide information about the child or adolescent in need of mental health services and the reasons for the referral.

What is the purpose of chat-h referral form?

The purpose of the chat-h referral form is to connect children and adolescents with the appropriate mental health services to address their needs.

What information must be reported on chat-h referral form?

The chat-h referral form must include the child or adolescent's name, age, contact information, a brief description of the mental health concerns, and any other relevant information.