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COMMUNITY HIGH RISK REFERRAL SCREENING FORM AIP NAME: Is the AIP (alleged incapacitated person) and APS (adult protective services) referral OR had an open APS case in the past 6 months? YES NO Ankhs
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How to fill out community high risk referral

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How to fill out community high risk referral

01
Start by gathering all the necessary information about the individual you want to refer for community high risk.
02
Obtain and fill out the referral form, which can usually be found on the community high risk program's website or can be obtained from the program's office.
03
Provide the individual's personal information such as name, address, phone number, and date of birth.
04
Indicate the reason for the referral, including any high-risk behaviors or concerns that make the person eligible for the program.
05
Provide any additional relevant information about the individual's social situation, medical history, or any other factors that may be important for the referral.
06
Make sure to sign and date the referral form.
07
Submit the completed referral form to the appropriate community high risk program office or follow the specified submission process.
08
Keep a copy of the referral form for your records, if necessary.
09
Follow up with the community high risk program to ensure that the referral has been received and processed.
10
Communicate with the individual about the referral and inform them of any further steps or actions they need to take.

Who needs community high risk referral?

01
Individuals who exhibit high-risk behaviors or are facing high-risk situations may benefit from a community high risk referral.
02
This could include individuals struggling with substance abuse, mental health issues, domestic violence, homelessness, or any other circumstances that put them at a higher risk.
03
The community high risk program aims to provide support and resources to individuals who need assistance in managing their risks and improving their overall well-being.
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Community high risk referral is a process of reporting individuals or groups in the community who are at high risk of experiencing negative outcomes.
Professionals, organizations, or individuals who have knowledge of individuals or groups at high risk are required to file community high risk referral.
Community high risk referral can be filled out by providing relevant information about the individual or group at high risk through a designated form or online portal.
The purpose of community high risk referral is to ensure that individuals or groups at high risk are provided with the necessary support and resources to prevent negative outcomes.
Information such as the identified individual or group at risk, specific risk factors, current situation, and any existing support systems must be reported on community high risk referral.
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