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Print FormREFERAL FORM DEVELOPMENTAL DUAL DIAGNOSIS OUTPATIENT PROGRAM 100 West 5th St. Hamilton, ON L8N 3K7 An integrated, shared service model providing specialized care to adults with an intellectual
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01
Here are the steps to fill out the developmental dual diagnosis outpatient form:
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Start by reading and understanding the instructions provided with the form.
03
Gather all the necessary information and documentation required to complete the form.
04
Begin by entering your personal details such as name, date of birth, address, and contact information.
05
Provide information about your developmental diagnosis, including any previous diagnoses or treatments received.
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Mention if you have any co-occurring mental health conditions or if you require any specific accommodations.
07
Complete the medical history section, including any past or current medications or treatments.
08
If applicable, provide details about any previous or ongoing outpatient programs or therapies undergone.
09
Sign and date the form to certify that the information provided is accurate and complete.
10
Review the completed form for any errors or missing information before submitting it.
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Submit the filled-out form according to the instructions provided.

Who needs developmental dual diagnosis outpatient?

01
Developmental dual diagnosis outpatient is suitable for individuals who:
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- Have been diagnosed with developmental disabilities such as autism spectrum disorder, intellectual disabilities, or communication disorders.
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- Require ongoing outpatient treatment and support for their developmental challenges.
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- Simultaneously experience mental health issues, such as anxiety, depression, or attention-deficit/hyperactivity disorder (ADHD).
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- Can benefit from a specialized program that addresses both their developmental and mental health needs.
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- Are medically stable and able to participate in an outpatient setting without requiring intensive 24-hour care or supervision.
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- Will benefit from a comprehensive approach that combines therapy, medication management, skill-building, and support services.
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- Have been assessed and recommended for dual diagnosis treatment by a qualified healthcare professional.
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Developmental dual diagnosis outpatient is a specialized program that provides mental health and substance abuse treatment for individuals with both developmental disabilities and co-occurring psychiatric disorders.
Healthcare providers, mental health professionals, and social workers are typically required to file developmental dual diagnosis outpatient forms for their patients.
To fill out a developmental dual diagnosis outpatient form, healthcare providers must gather information on the patient's developmental disability, psychiatric diagnosis, treatment plan, and progress.
The purpose of developmental dual diagnosis outpatient is to provide integrated treatment for individuals with both developmental disabilities and mental health disorders to improve their overall well-being and quality of life.
Information such as the patient's developmental disability diagnosis, psychiatric diagnosis, treatment goals, medications, progress notes, and any changes in the treatment plan must be reported on developmental dual diagnosis outpatient forms.
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