Get the free AFLP Referral Form - ochcacom

Health Care Agency Adolescent Family Life Program REFERRAL FORM I give my permission to be referred to the Adolescent Family Life Program (AFLP). (Optional) Signature: Date: Please complete all known

How to fill out aflp referral form

Point by point instructions on how to fill out an AFLP referral form:

1. Start by carefully reading the instructions provided on the AFLP referral form. This will ensure that you understand the purpose and requirements of the form.
2. Begin by entering your personal information in the designated sections. This might include your name, contact details, and any other relevant identification information.
3. If required, provide details about your current employment or organization. This information may be necessary to determine eligibility for AFLP services or to track referral sources.
4. Next, provide information about the individual or organization being referred. This may include their name, contact information, and any relevant background information or history that will assist in the evaluation process.
5. In the referral reason or description section, clearly state why you are referring the individual or organization to the AFLP. Provide sufficient details and background information to help the AFLP team understand the specific issue or concern that needs to be addressed.
6. Ensure that you have included any supporting documents that may be required. This could include medical records, assessments, or other relevant documentation that will aid in the evaluation and decision-making process.
7. Review the completed form to ensure all fields are filled out accurately and completely. Double-check for any errors or missing information. It's important to provide as much detail as possible to help the AFLP team make an informed decision.
8. Sign and date the form, if necessary. Some referral forms may require a signature to confirm that the information provided is accurate and that you have obtained consent from the individual or organization being referred.
9. Finally, submit the completed referral form through the designated method outlined on the form. This may include mailing, faxing, or submitting online, depending on the instructions provided.

Who needs an AFLP referral form?

AFLP referral forms are typically used by individuals, professionals, or organizations who need to refer someone to the AFLP for assistance. This may include healthcare professionals, social workers, educators, or individuals seeking support for themselves or someone else. The reasons for referral can vary widely but often involve issues related to family support, child development, special education, behavioral challenges, or mental health concerns.

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