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Adult Psychiatric Clinic Referral Form Phone 604.873.0103 Fax 604.873.3095PATIENT INFORMATION Name: LastFirstPHN:Phone:DOB:Address:(include postal code)Email:GenderREFERRING DOCTOR (PLEASE PRINT LEGIBLY)
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What is adult psychiatric clinic referral?
Adult psychiatric clinic referral is a process by which individuals are referred to a psychiatric clinic for evaluation and treatment of mental health issues.
Who is required to file adult psychiatric clinic referral?
Healthcare providers, social workers, or family members may be required to file an adult psychiatric clinic referral for individuals in need of mental health services.
How to fill out adult psychiatric clinic referral?
An adult psychiatric clinic referral can be filled out by providing the individual's personal information, medical history, and reason for referral.
What is the purpose of adult psychiatric clinic referral?
The purpose of adult psychiatric clinic referral is to ensure that individuals receive appropriate mental health evaluation and treatment.
What information must be reported on adult psychiatric clinic referral?
Information such as the individual's name, age, address, contact information, medical history, and reason for referral must be reported on the adult psychiatric clinic referral form.
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