Get the free Kairos Referral Form - Youth Diversion Program - youthdiversion

PAIRS REFERRAL FOR SERVICE 559 Begot Street, Kingston Ontario, K7K 3E1 Telephone (613) 5484535 Fax (613)5481747 When referring a young person to the PAIRS program, please fill in the referral form

How to fill out kairos referral form

How to fill out a Kairos referral form:

1. Start by gathering all the necessary information. The referral form typically requires details such as the client's name, contact information, date of birth, and any relevant medical or behavioral health history.
2. Carefully review the referral form to ensure you understand each section. It may include questions about the client's reason for referral, symptoms or concerns, previous treatments, and any specific goals or objectives.
3. Fill out all the required fields accurately and completely. Double-check the information you provide to avoid any errors or omissions. If there are any sections that are not applicable to the client, make a note or mark them as "N/A."
4. Consult with the client or their legal guardian if necessary. Some sections may require the client's input or consent, such as releasing medical records or obtaining their signature. Clarify any doubts or questions they may have before completing these sections.
5. Ensure that the referral form is signed and dated appropriately. The form may have spaces for the referring healthcare provider's signature, as well as the client's or legal guardian's signature if required. Make sure all necessary signatures are obtained to validate the referral.

Who needs a Kairos referral form:

1. Individuals seeking mental health or behavioral health services may require a Kairos referral form. This could include individuals experiencing emotional distress, psychiatric disorders, substance abuse issues, or developmental disabilities.
2. Healthcare providers, such as primary care physicians, psychologists, therapists, or social workers, who wish to refer their patients or clients to Kairos for specialized care or treatment may also need to complete a referral form.
3. Legal guardians or family members seeking assistance for a loved one who is struggling with mental health or behavioral health challenges may also be required to fill out a Kairos referral form.

It is essential to note that the specific requirements for the Kairos referral form may vary depending on the region or specific program. It is advised to consult with Kairos or the specific program to obtain the most accurate and up-to-date information on filling out the referral form.

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What is kairos referral form?

Kairos referral form is a form used to refer individuals to the Kairos program for rehabilitation.

Who is required to file kairos referral form?

Law enforcement agencies, courts, or other authorized entities are required to file the Kairos referral form.

How to fill out kairos referral form?

The Kairos referral form can be filled out electronically or on paper, providing information about the individual being referred.

What is the purpose of kairos referral form?

The purpose of the Kairos referral form is to initiate the process of referring individuals to the Kairos program for support and rehabilitation.

What information must be reported on kairos referral form?

The Kairos referral form must include the individual's name, contact information, offense details, and reason for referral.