Get the free Crisis/IRTS Assessment & Referral Form

REQUIRED INFORMATION:Crisis/ITS Assessment & Referral Form Crisis/ITS ResidenceName: DOB:Hennepin County Medical Center P: 6123525600 F: 6123525609Med Rec #: Account #Referral Source:Referral Source

How to fill out crisisirts assessment amp referral

How to fill out crisisirts assessment amp referral

1. To fill out the CrisisIRTS assessment and referral form, follow these steps:
2. Begin by gathering all relevant information about the individual in crisis, including their personal details, contact information, and any known mental health history.
3. Start the form by entering the individual's name, date of birth, address, and other identifying information.
4. Provide a brief description of the crisis situation, including any immediate dangers or risks to the individual or others involved.
5. Assess the severity of the crisis by using the CrisisIRTS assessment scale, which measures factors such as level of distress, impairment in daily functioning, and ability to manage personal safety.
6. Use the CrisisIRTS referral section to indicate the appropriate level of care needed for the individual, such as emergency psychiatric evaluation, crisis counseling, or referral to community mental health services.
7. Include any additional notes or observations that may be helpful for the responding crisis team or mental health professionals.
8. Review the completed form for accuracy and completeness before submitting it to the designated recipient or agency responsible for crisis response.
9. Follow any additional instructions or protocols established by your organization or jurisdiction for submitting and documenting crisis assessments and referrals.
10. Remember to treat all information obtained during the assessment process with confidentiality and ensure the individual's privacy rights are respected.

Who needs crisisirts assessment amp referral?

1. Anyone experiencing a mental health crisis can benefit from CrisisIRTS assessment and referral.
2. This includes individuals who are experiencing severe emotional distress, exhibiting suicidal ideation or self-harm behaviors, or struggling with symptoms of a mental illness.
3. The CrisisIRTS assessment helps determine the appropriate level of care and intervention needed to ensure the person's safety and well-being.
4. It is typically used by mental health professionals, crisis hotline operators, emergency responders, and other individuals involved in crisis intervention and mental health support.

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