Get the free NON MEDICAL CARE REFERRAL FOLLOW-UP FORM - lphi

Louisiana Reentry Initiative Research Study Version 1.0 3/25/13 NON-MEDICAL CARE REFERRAL FOLLOWUP FORM INTERVENTION (Check one) Referring Agency CARP NO/AIDS Task Force Client Name: Client Phone:

How to fill out non medical care referral

How to fill out a non medical care referral:

1. Start by ensuring that you have the necessary form or document to fill out the non medical care referral. This may vary depending on your specific situation or the organization requesting the referral.
2. Begin by providing your personal information, such as your full name, contact details, and any other required identification information.
3. If applicable, include the name and contact information of the individual who will be receiving the non medical care services.
4. Clearly state the reason for the referral, describing the type of non medical care needed and any specific requirements or preferences.
5. Include any relevant medical information or history that can help in assessing the appropriate non medical care services required.
6. Specify the duration or frequency of the non medical care needed, whether it is a one-time service or ongoing assistance.
7. If necessary, provide any additional details or instructions that may be important for the referral, such as preferred providers or specific care instructions.
8. Review the completed referral form for accuracy and completeness before submitting it to the appropriate party or organization.

Who needs non medical care referral:

1. Individuals who require assistance with activities of daily living, such as bathing, dressing, or meal preparation, but do not need any medical intervention.
2. Elderly individuals who may need companionship, help with household chores, or transportation services.
3. People with disabilities or chronic illnesses who need assistance with tasks or activities that are not directly related to their medical condition.
4. Families or caregivers seeking respite care or temporary assistance in caring for a loved one.
5. Individuals transitioning from a hospital or rehabilitation facility back to their home and need help with their daily routine until they fully recover.
6. Patients who have been advised by their healthcare provider to seek non medical care services as part of their treatment plan or to enhance their overall well-being.

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What is non medical care referral?

Non medical care referral is a process in which individuals are referred to receive care or services that are not related to medical treatment.

Who is required to file non medical care referral?

Non medical care referral may be filed by social workers, case managers, or other professionals who are coordinating care for an individual.

How to fill out non medical care referral?

Non medical care referral can be filled out by providing the necessary information about the individual in need of care, the type of care required, and the contact information for the referring professional.

What is the purpose of non medical care referral?

The purpose of non medical care referral is to ensure that individuals receive the care and services they need to maintain their well-being and quality of life.

What information must be reported on non medical care referral?

Non medical care referral must include the individual's name, contact information, medical history, current needs, and any specific requirements for care.