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REFERRAL TO HEALTHY START A Program of Charlotte Behavioral Health Care Phone (941× 3476460 Fax (941× 5755109 Please provide the information below that will help us provide the best level of service.
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How to fill out referral to healthy start
How to fill out a referral to Healthy Start:
01
Obtain a referral form from your healthcare provider or from the Healthy Start program.
02
Fill out your personal information accurately, including your name, address, phone number, and date of birth.
03
Provide information about your healthcare provider, such as their name, address, and contact details.
04
Indicate the reason for the referral, such as pregnancy, newborn care, breastfeeding support, or infant and child health.
05
Include any additional information that might be relevant to your situation, such as any medical conditions or concerns.
06
Sign and date the referral form, ensuring all information is legible and complete.
07
Submit the referral form to the appropriate Healthy Start program, either in person or by mail, ensuring it reaches them within the specified time frame.
Who needs a referral to Healthy Start:
01
Pregnant women who may require additional support and resources for a healthy pregnancy.
02
New mothers who may need assistance with breastfeeding, infant care, or postpartum health.
03
Families with infants or young children who may benefit from guidance and education on child health and development.
04
Individuals with specific health concerns or risk factors that require specialized care and support.
Remember, the eligibility for a Healthy Start referral may vary depending on your location and specific program requirements. It is recommended to consult with your healthcare provider or the Healthy Start program in your area to determine if you or someone you know qualifies for a referral.
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What is referral to healthy start?
Referral to Healthy Start is a process where an individual or organization connects pregnant women and families with young children to resources and services that promote healthy pregnancies and positive parenting.
Who is required to file referral to healthy start?
Healthcare providers, social workers, community organizations, and other professionals who work with pregnant women and families with young children are required to file referrals to Healthy Start.
How to fill out referral to healthy start?
Referrals to Healthy Start can be filled out online, over the phone, or in person by providing basic information about the pregnant woman or family in need.
What is the purpose of referral to healthy start?
The purpose of referral to Healthy Start is to ensure that pregnant women and families with young children have access to the resources and services they need to have healthy pregnancies and positive parenting experiences.
What information must be reported on referral to healthy start?
Information such as contact information for the pregnant woman or family, due date or age of children, any specific needs or concerns, and any other relevant information must be reported on a referral to Healthy Start.
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