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Richmond Adult Community Mental Health Addiction Services Adult Mental Health Team / Mental Health Outpatient Services / Transitions Central Intake Phone 604 244-5488 Fax 604 244-5487 REFERRAL FORM INDEPENDENT MEDICAL EXAMINATIONS AND MEDICOLEGAL ASSESSMENTS FOR INSURANCE / LEGAL MATTERS ARE NOT PROVIDED. FOR URGENT CRISIS INTERVENTION CONTACT LOCAL MHES / EMERGENCY DEPARTMENT. Client Information Name PHN Surname First Address DOB Gender Primary Phone Other Phone Can message be left Yes No...
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01
Start by obtaining the necessary forms from the Richmond Adult Community Mental Health center.
02
Fill out personal information such as name, address, contact details, and date of birth.
03
Provide relevant details about your mental health history, including any diagnoses or medications you are currently taking.
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Fill out information about your previous mental health treatment, such as therapy sessions or hospitalizations.
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Answer any additional questions regarding your current mental health status or concerns.
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Review the completed form for accuracy and completeness.
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Submit the filled-out form to the Richmond Adult Community Mental Health center either in person or via mail.
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If required, schedule an appointment with a mental health professional for further assessment and assistance.

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Individuals who are experiencing mental health issues or concerns.
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Family members or friends of individuals who may benefit from Richmond Adult Community Mental Health services and support.
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Richmond Adult Community Mental Health Team provides mental health services to adults in the Richmond area.
Healthcare providers and organizations serving adults in the Richmond area are required to file.
The form can typically be filled out online or submitted via mail, following the instructions provided by the Richmond Adult Community Mental Health Team.
The purpose is to gather information about the mental health services provided to adults in the community for data analysis and improvement of services.
Information such as number of patients served, types of services provided, outcomes of treatments, and any challenges faced in providing mental health services to adults.
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