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(Folio Number:) Counselling Referral Form Referral Details Name Client ref number (for office use) Address Email address Home telephones no. Mobile no. Who is being referred? Age & Date of birth Emergency
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How to fill out counselling referral form

How to fill out a counselling referral form:
01
Start by gathering all the necessary information. The referral form will typically ask for the client's basic details such as name, contact information, and date of birth.
02
Next, provide a brief description of the reason for the referral. This could include the client's presenting issue or the specific concerns that require counselling.
03
Indicate any urgency or priority for the referral. If the client's situation requires immediate attention, it's important to highlight this on the form.
04
Specify the type of counselling service needed. This could include individual therapy, couples therapy, family therapy, or any other specialized services.
05
If the client has a preferred counsellor, make sure to include their name or indicate a preference for a specific therapist or counselling approach.
06
Identify any relevant supporting documents that should be included with the referral form. This could include medical records, previous counselling history, or any assessments or reports relevant to the client's wellbeing.
07
Lastly, ensure that the counselling referral form is complete and signed by both the referring person (such as a healthcare professional) and the client.
Who needs a counselling referral form?
01
Individuals seeking professional mental health support: A counselling referral form is needed when someone recognizes they could benefit from counseling and wants to connect with a therapist or counselor to receive guidance and support for their mental health needs.
02
Healthcare professionals: A counselling referral form is often used by healthcare professionals like doctors, psychiatrists, or psychologists who may diagnose a mental health condition or recognize that their patient could benefit from counseling and refer them to a qualified therapist.
03
Educational institutions: Schools or universities may provide counselling services to their students. In such cases, a referral form may be used to facilitate the process of connecting students to the appropriate counselors within the school or university setting.
04
Employee assistance programs (EAP): Some companies offer EAPs, which provide employees with access to counseling services. In these cases, a referral form may be used to initiate the process of connecting employees with EAP counselors.
05
Organizations or agencies: Various organizations or agencies may have their own counseling services or partnerships with therapists. A counseling referral form may be required to engage their services for clients or individuals seeking support.
Overall, a counselling referral form ensures that the necessary information is provided to facilitate appropriate and effective care by matching individuals with the most suitable therapist or counseling service.
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What is counselling referral form?
The counselling referral form is a document used to refer an individual to counselling services for assistance with personal or emotional issues.
Who is required to file counselling referral form?
Anyone who believes that an individual could benefit from counselling services is required to file a counselling referral form.
How to fill out counselling referral form?
To fill out a counselling referral form, you must provide the individual's identifying information, reason for referral, and any relevant background information.
What is the purpose of counselling referral form?
The purpose of the counselling referral form is to connect individuals in need with appropriate counselling services to address their emotional or personal issues.
What information must be reported on counselling referral form?
The counselling referral form must include the individual's name, contact information, reason for referral, and any relevant background or context.
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