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Los Angeles Unified School DistrictSTUDENT HEALTH AND HUMAN SERVICESSCHOOL MENTAL HEALTH SMH Referral Cover Sheet School/Community Referral DATE: From: Name/TitleEmail address: Telephone Number(s):

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How to fill out smh referral cover sheet

01

To fill out the smh referral cover sheet, follow these steps:

02

Start by entering the patient's personal information such as their name, date of birth, and contact details.

03

Specify the medical condition or reason for referral in the appropriate section.

04

Provide the referring physician's name, contact information, and any relevant medical credentials.

05

Indicate the specialist or healthcare provider to whom the referral is being made.

06

Include any additional details or instructions that may be necessary for the recipient.

07

Review the completed cover sheet for accuracy and completeness before submitting it.

Who needs smh referral cover sheet?

01

The smh referral cover sheet is required by healthcare professionals or organizations who are referring a patient to a specialist or another healthcare provider. It ensures that all relevant information is provided for a seamless transfer of care.

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What is smh referral cover sheet?

The SMH referral cover sheet is a document used to provide information about a patient being referred to a mental health service.

Who is required to file smh referral cover sheet?

Healthcare providers or facilities referring patients to mental health services are required to file the SMH referral cover sheet.

How to fill out smh referral cover sheet?

The SMH referral cover sheet can be filled out by providing patient information, reason for referral, medical history, and any other relevant details.

What is the purpose of smh referral cover sheet?

The purpose of the SMH referral cover sheet is to ensure that all necessary information is communicated effectively between healthcare providers and mental health services.

What information must be reported on smh referral cover sheet?

Information such as patient demographics, medical history, reason for referral, and any other relevant details must be reported on the SMH referral cover sheet.

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