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CHILDREN MENTAL HEALTH REFERRAL FOR ASSESSMENT PRIORITY CRITERIA TOOL PLEASE PRINT CLEARLY Date: Provincial Health Care Number: Patient Name: Sex: M F DOB / / year month day Reason for referral: Referring
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How to fill out children39s mental health referral

How to fill out a children's mental health referral:
01
Gather necessary information: Before filling out the referral, make sure you have all the necessary information about the child. This may include their full name, age, contact information, and any relevant medical or psychological history.
02
Consult with the child's primary caregiver: It's important to involve the child's primary caregiver, such as a parent or guardian, in the referral process. They may have valuable insights or information to provide.
03
Contact a mental health professional: Reach out to a mental health professional or clinic that specializes in children's mental health. They will have the necessary referral forms and can guide you through the process.
04
Complete the referral form: Fill out the referral form accurately and completely. Provide all the requested information, including details about the child's symptoms, concerns, and any previous therapies or treatments they have received.
05
Include relevant documentation: Attach any relevant documentation that may support the referral, such as medical records, assessment reports, or academic reports. This additional information can help the mental health professional better understand the child's situation.
06
Submit the referral: Once the referral form is completed and necessary documentation is attached, submit it to the mental health professional or clinic as instructed. This may involve mailing it, dropping it off in person, or submitting it electronically through an online portal.
Who needs a children's mental health referral:
01
Children experiencing emotional or behavioral difficulties: A referral may be necessary for children who are displaying signs of emotional or behavioral difficulties that are affecting their day-to-day functioning or overall well-being. This could include symptoms such as frequent mood swings, withdrawal from social activities, or difficulty concentrating.
02
Concerned parents, guardians, or caregivers: Parents, guardians, or caregivers who have concerns about a child's mental health may seek a referral to ensure that appropriate assessments and interventions can take place. They may have noticed significant changes in the child's behavior, academic performance, or social interactions.
03
Primary healthcare providers or educators: Primary healthcare providers, such as pediatricians or family doctors, as well as educators, may recommend a mental health referral if they observe worrisome signs in a child's physical or academic development. They play a crucial role in identifying potential mental health concerns and referring the child to specialized professionals for further assessment and support.
Remember, every child is unique, and the decision to seek a mental health referral should be based on individual circumstances and professional recommendations. It's essential to prioritize children's mental health and seek appropriate help when needed.
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What is children's mental health referral?
Children's mental health referral is a process through which a child is recommended to receive mental health services or evaluation by a healthcare professional.
Who is required to file children's mental health referral?
Parents, teachers, guidance counselors, healthcare providers, or any concerned individual can file a children's mental health referral for a child in need.
How to fill out children's mental health referral?
To fill out a children's mental health referral, one must provide information about the child's symptoms, behaviors, and any relevant medical history. The referral form is usually available online or through the child's school or healthcare provider.
What is the purpose of children's mental health referral?
The purpose of children's mental health referral is to connect children in need with appropriate mental health services and support to address their emotional or behavioral concerns.
What information must be reported on children's mental health referral?
Information reported on a children's mental health referral typically includes the child's name, age, symptoms, the reason for referral, any relevant medical history, and contact information for the child's parent or guardian.
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