Get the free DHS Mental Health Referral ver 512 rev - file lacounty

COUNTY OF LOS ANGELES DEPARTMENT OF HEALTH SERVICES DEPARTMENT OF MENTAL HEALTH REFERRAL FROM DEPARTMENT OF HEALTH SERVICES Patient Information: HULA ID#: L.A. Care (NON/SPD) Other: Name: DOB: Address:

How to fill out dhs mental health referral

Who needs dhs mental health referral?

1. Individuals who are seeking assistance with their mental health and are eligible for services provided by the Department of Human Services (DHS).
2. People who may be experiencing emotional distress, mental illness, or other mental health issues that require professional support and intervention.
3. Individuals who are referred by healthcare providers, social workers, or other professionals who recognize the need for specialized mental health services.

How to fill out dhs mental health referral:

1. Begin by obtaining the necessary referral form from the DHS or your healthcare provider. This form can often be found on the DHS website or may be provided by your healthcare professional.
2. Fill out the personal information section on the form, including your full name, date of birth, address, phone number, email address, and any other required contact details.
3. Provide your social security number or any other identification numbers that may be required by the DHS for their internal records or to verify your eligibility for mental health services.
4. Indicate the reason for the referral and briefly describe your mental health concerns or symptoms. Be as specific as possible to ensure the appropriate services are provided.
5. If applicable, provide any relevant medical history, previous mental health treatment received, or medications currently being taken. This information can help the mental health professional in assessing your needs effectively.
6. If someone else is completing the referral form on your behalf, ensure that their contact details and relationship to you are included in the appropriate section.
7. Review the completed form for accuracy and completeness before submitting it. Make sure all required fields are filled out and any additional supporting documents are attached, if necessary.
8. Submit the filled-out referral form to the designated DHS office or the healthcare provider who will process your referral. Follow any specific instructions provided on the form or by the referring professional.
9. Keep a copy of the referral form and any related documentation for your records. This will serve as proof of your request and can be used for future reference if needed.

Note: It is important to consult the specific guidelines and procedures of your local DHS office or healthcare provider regarding how to fill out their mental health referral form accurately.

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What is dhs mental health referral?

DHS mental health referral is a process where individuals are referred to mental health services provided by the Department of Human Services.

Who is required to file dhs mental health referral?

Individuals who are in need of mental health services or those who are mandated by a court order to seek mental health treatment are required to file DHS mental health referral.

How to fill out dhs mental health referral?

DHS mental health referral can be filled out by contacting the Department of Human Services and completing the necessary forms and paperwork.

What is the purpose of dhs mental health referral?

The purpose of DHS mental health referral is to ensure that individuals receive the necessary mental health services and support to improve their well-being.

What information must be reported on dhs mental health referral?

The information reported on DHS mental health referral includes personal details of the individual, mental health concerns, treatment history, and any court orders mandating mental health treatment.