Get the free ACT Referral form - York County

YORK/ADAMS REFERRAL FOR ASSERTIVE COMMUNITY TREATMENT (ACT) Fax to HealthChoices at 1-717-771-9590 Demographic, Identifying and Contact Information: (All the following information is required to activate

How to fill out act referral form

How to fill out an ACT referral form:

1. Start by obtaining the ACT referral form from the appropriate organization or institution. This form can usually be downloaded from their website or obtained in person.
2. Fill in the personal information section, including your full name, contact information, and any other required details such as your date of birth or student ID number.
3. Provide details about the referring organization or individual. This may include the name of your school, college, employer, or mentor who is recommending you for the ACT.
4. Indicate the reason for the referral. This could be for academic purposes, career advancement, or personal development.
5. Fill in any additional information that may be required, such as specific goals or objectives you hope to accomplish through the referral.
6. Sign and date the form to certify that the information provided is accurate to the best of your knowledge.
7. Submit the completed form to the appropriate recipient, whether it's an admissions office, employer, or another relevant authority.

Who needs an ACT referral form:

1. High school students who are seeking college admissions may need an ACT referral form to support their application.
2. Individuals looking for scholarships or financial aid may be required to submit an ACT referral form as part of the application process.
3. Students or professionals seeking career advancement or training opportunities may need an ACT referral form to demonstrate their qualifications and potential.

Note: The specific requirements for an ACT referral form may vary depending on the organization or institution, so it's always important to review the instructions provided and ensure that all necessary information is included.

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