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OMB NO. 09300270 Expiration Date 09/30/2018RESPONSE CARD Think about your thoughts, feelings, and behavior DURING THE PAST MONTH. Use these frequency rating options to help answer how often the problem
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How to fill out childyouth assessment and referral:

01
Start by gathering all necessary information about the child or youth in question, including their personal details, medical history, and any concerns or issues that need to be addressed.
02
Carefully review the assessment form and ensure that all sections are properly filled out. Provide thorough and accurate responses to each question, providing as much detail as possible.
03
Pay close attention to any specific instructions or guidelines provided with the assessment form, as these may vary depending on the organization or agency requesting the referral.
04
If you are unsure about how to answer a particular question or what information is required, don't hesitate to reach out for clarification. It's important to provide the most comprehensive and clear assessment possible.
05
Once the assessment form is completed, double-check all information for accuracy and make any necessary corrections or additions.
06
Submit the completed assessment and referral form to the appropriate individual or department, ensuring that all required documents and supporting materials are included.
07
Keep a copy of the completed assessment and referral form for your records, as well as any additional supporting documents or evidence that may be needed in the future.

Who needs childyouth assessment and referral?

01
Child or youth experiencing behavioral, emotional, or developmental challenges.
02
Families seeking support and assistance for their child or youth.
03
Professionals working with children or youth in various settings such as schools, healthcare facilities, or social services.
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Child/youth assessment and referral is a process used to evaluate and address the needs of children and youth who may be at risk or in need of support or services.
Child/youth assessment and referral may be required to be filed by healthcare professionals, educators, social workers, or other professionals who work with children and youth.
Child/youth assessment and referral forms typically require information about the child/youth's background, current situation, needs, and any recommended interventions or services.
The purpose of child/youth assessment and referral is to identify and address the needs of children and youth in order to provide appropriate support and services to help them thrive.
Information that may be reported on child/youth assessment and referral forms includes demographic information, medical history, social history, current concerns, and recommendations for interventions or services.
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