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IL 462-1222 (R-09-15) Uniform Screening and Referral Form. -0- Copies. Printed by Authority of the State of Illinois. Uniform Screening and Referral Form.

How to fill out screening and referral form

How to fill out screening and referral form

1. To fill out the screening and referral form, follow these steps:
2. Start by opening the form document on your computer or printing a hard copy.
3. Read the instructions provided at the beginning of the form to understand the purpose and requirements.
4. Begin by filling out your personal information, such as your name, contact details, and any required identification numbers.
5. Move on to the section that requires information about the person being screened or referred. Provide accurate details regarding their background, current situation, and any relevant history.
6. Pay close attention to any specific questions or fields that require additional documentation or supporting evidence. Be sure to attach any required files or records, if applicable.
7. Double-check all the information you have entered before submitting the form to ensure accuracy and completeness.
8. If submitting electronically, save a copy of the completed form for your records. If submitting a hard copy, make a photocopy before sending or handing it in.
9. If necessary, seek assistance from a qualified professional or contact the relevant authority for any clarifications or questions you may have during the process.
10. Once you have completed the form, submit it through the designated channel or to the specified recipient. Follow any additional instructions provided.

Who needs screening and referral form?

1. The screening and referral form is typically required for individuals who:
2. - Are seeking certain social services or benefits that require an initial evaluation or assessment.
3. - Need to access specialized healthcare or mental health services.
4. - Have been identified or referred by a professional or organization for further evaluation or assistance.
5. - Are involved in legal processes where screening and referral is part of the protocol.
6. - Need to provide specific information and consent for a targeted program or resource.
7. Each organization or authority may have its own criteria and requirements for who needs to fill out the form. It is essential to consult the relevant guidelines or contact the specific entity to determine if the screening and referral form is needed in a particular situation.

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What is screening and referral form?

Screening and referral form is a document used to assess an individual's needs and determine if they require further assistance or services.

Who is required to file screening and referral form?

Individuals or organizations responsible for coordinating services or providing support may be required to file a screening and referral form.

How to fill out screening and referral form?

To fill out a screening and referral form, one must provide detailed information about the individual in need, their specific needs, and any relevant background information.

What is the purpose of screening and referral form?

The purpose of screening and referral form is to ensure that individuals receive appropriate support and services based on their needs.

What information must be reported on screening and referral form?

Information reported on screening and referral form may include personal information, needs assessment, support services required, and any additional notes or comments.