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CHAP PROGRAM REFERRAL AGREEMENT In signing this CHAP Program Referral Agreement I acknowledge and agree that: I am not a CHAP Program employee. I am an independent contractor and will contract directly

How to fill out chap program referral agreement

How to fill out chap program referral agreement:

1. Obtain a copy of the chap program referral agreement form. This can usually be obtained from the chap program office or website.
2. Carefully read through the entire agreement to understand the terms and conditions. Take note of any specific requirements or guidelines that need to be followed.
3. Fill in the necessary information accurately. This may include your name, contact details, and any other relevant personal information.
4. Provide the details of the person or organization being referred to the chap program. Include their name, contact information, and any additional information required.
5. Review the agreement for any additional sections or clauses that need to be completed. Pay close attention to any areas that may require signatures or initials.
6. If there are any specific requirements or documents that need to be attached, make sure to include them with the referral agreement.
7. Double-check all the information provided to ensure its accuracy and completeness. Make any necessary revisions or corrections before submitting the form.
8. Submit the completed chap program referral agreement to the designated office or individual. This may involve mailing it, emailing it, or submitting it in person, depending on the instructions provided.

Who needs chap program referral agreement?

1. Medical professionals: Doctors, nurses, therapists, and other healthcare providers who offer services that qualify for the chap program may need to complete a referral agreement.
2. Chap program coordinators: Individuals responsible for managing and coordinating the chap program may require referral agreements to ensure proper documentation and communication.
3. Referral sources: Organizations or individuals who refer clients or patients to the chap program may also be required to complete a referral agreement. This helps establish a formal agreement and clarifies expectations for all parties involved.

Remember that the specific requirements for the chap program referral agreement may vary depending on the program and the organization administering it. It is essential to carefully review the instructions and guidelines provided to ensure compliance with the necessary procedures.

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