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PASADENA UNIFIED SCHOOL DISTRICT EDUCATION CENTER HEALTH PROGRAMS Our Children. Learning Today. Leading Tomorrow. MENTAL HEALTH REFERRAL FOR HOME HOSPITAL INSTRUCTION School: Please complete the Student
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How to fill out mental health referral for

01
Start by obtaining a mental health referral form from the appropriate source, such as your healthcare provider or employer.
02
Begin filling out the referral form by providing your personal information, including your name, contact details, and any identification numbers if required.
03
Specify the reason for seeking mental health referral, whether it is for a particular issue or as part of routine check-up or treatment.
04
Provide a detailed description of your current mental health concerns, symptoms, and any relevant medical history that may assist the referral process.
05
Include any specific preferences or requirements you may have regarding the type of mental health professional or facility you wish to be referred to.
06
If applicable, provide information about your insurance coverage or financial arrangements for accessing mental health services.
07
Review and double-check all the information you have filled in the referral form to ensure accuracy and completeness.
08
Submit the completed referral form to the designated recipient, whether it is your healthcare provider, insurance company, or any other relevant entity as instructed.

Who needs mental health referral for?

01
Anyone who is experiencing mental health issues or concerns can potentially benefit from a mental health referral.
02
Individuals who are struggling with symptoms of anxiety, depression, mood disorders, stress, trauma, or any other psychological condition may require a mental health referral.
03
Those who have noticed a decline in their overall mental well-being, functionality, or relationships can also benefit from seeking a mental health referral.
04
People facing significant life transitions, such as bereavement, divorce, unemployment, or relocation, may find it helpful to seek support through a mental health referral.
05
Certain high-risk groups, including individuals with a history of substance abuse, self-harm, suicidal thoughts, or those who have experienced trauma or abuse, may especially need a mental health referral.
06
It is important to remember that anyone can seek a mental health referral, and doing so can facilitate access to appropriate care, support, and interventions.
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