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Patients Full Name: Address: Geriatric Psychiatry/ Seniors Mental Health Program Healthy Living Group Referral Phone: (H) (W) (C) D.O.B. MAN Gender HAN Exp Referral Date: Diagnosis: Is the Client

How to fill out geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-form

How to fill out geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth:

1. Start by entering your personal information. This includes your name, address, phone number, and date of birth. Make sure to provide accurate and up-to-date information.
2. Next, indicate your healthcare provider's name and contact information. This can be your primary care physician or the healthcare professional referring you to the geriatric psychiatry seniors mental health program.
3. Specify the reason for referral. This could include mental health concerns such as depression, anxiety, cognitive decline, or any other geriatric mental health issues you may be experiencing. Provide a brief description of your symptoms or concerns.
4. If you have any known medical conditions, allergies, or medications, you should mention them on the form. It is crucial to provide accurate information about your medical history to ensure appropriate care during the program.
5. Indicate any additional support services or referrals you may require. This could include assistance with transportation, interpreters, or specific accommodations due to physical limitations. Be clear about your needs to ensure your experience in the program is tailored to your individual requirements.
6. If you have already had previous assessments or treatments related to your mental health, provide details of these on the form. This information will help your healthcare providers gain a comprehensive understanding of your mental health journey.

Who needs geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

Individuals who can benefit from the geriatric psychiatry seniors mental health program may include:

1. Seniors experiencing mental health concerns such as depression, anxiety, or cognitive decline.
2. Family members or caregivers of seniors who notice changes in their mental well-being.
3. Healthcare professionals who believe their elderly patients could benefit from specialized geriatric mental health care.
4. Individuals interested in healthy aging and seeking support with maintaining their mental well-being as they age.
5. Seniors who wish to join a healthy living group to engage in social activities and learn strategies to improve their mental health.
6. Individuals looking for resources and information about geriatric mental health and related programs available through cdha nshealth.

By filling out the geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth form, both individuals in need of mental health support and healthcare professionals can initiate and access the appropriate geriatric mental health services and resources.

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What is geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

The geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth is a referral form for seniors' mental health program in CDHA NSHealth.

Who is required to file geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

Healthcare providers or clinicians referring seniors to the mental health program are required to file the form.

How to fill out geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

The form must be filled out with the patient's demographic information, medical history, reason for referral, and any relevant details.

What is the purpose of geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

The purpose of the form is to facilitate the referral process for seniors needing mental health services.

What information must be reported on geriatric-psychiatryseniors-mental-health-program-healthy-living-group-referral-formpdf - cdha nshealth?

Information such as patient's name, date of birth, contact information, medical history, reason for referral, and referring clinician's details must be reported on the form.