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LIGHTHOUSE SUICIDE PREVENTION REFERRAL FORM Incomplete referral form may result in processing delays and impact on the clients care coordination Please sign and submit the completed form by fax to
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How to fill out lighthouse suicide prevention referral

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How to fill out lighthouse suicide prevention referral

01
To fill out the Lighthouse suicide prevention referral, follow these steps:
02
- Begin by obtaining the referral form from Lighthouse or their website.
03
- Fill in your personal information, such as your name, contact details, and any relevant identification numbers.
04
- Provide the details of the individual whom you are referring for suicide prevention, including their name, contact information, and any other relevant information.
05
- Specify the reason for the referral, detailing the concerns or circumstances that have prompted your decision.
06
- Include any additional information or relevant notes that may help the professionals at Lighthouse understand the situation better.
07
- Sign and date the referral form to validate its authenticity.
08
- Make sure to securely submit the completed referral form to Lighthouse, either through their website, email, or by visiting their office in person.

Who needs lighthouse suicide prevention referral?

01
Anyone who is at risk of suicide or shows signs of suicidal thoughts or behaviors may need a Lighthouse suicide prevention referral.
02
This includes, but is not limited to, individuals who:
03
- Express direct or indirect suicidal ideation.
04
- Exhibit symptoms of severe depression or hopelessness.
05
- Have a history of self-harm or suicide attempts.
06
- Recently experienced traumatic events or significant life changes.
07
- Lack a reliable support system or feel isolated.
08
Lighthouse suicide prevention referral is aimed at providing crucial support and intervention to those who are at risk, helping them address their mental health concerns and preventing potential suicide attempts.
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Lighthouse suicide prevention referral is a program designed to provide support and resources for individuals who are at risk of suicide.
Healthcare providers, social workers, and mental health professionals are required to file lighthouse suicide prevention referral.
To fill out lighthouse suicide prevention referral, individuals must gather relevant information about the individual at risk and submit the form to the appropriate authorities.
The purpose of lighthouse suicide prevention referral is to connect individuals in crisis with the necessary help and support to prevent suicide.
Information such as the individual's contact details, mental health history, current crisis situation, and risk factors for suicide must be reported on lighthouse suicide prevention referral.
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