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See back for clinic contact information. PHYSICAL THERAPY REFERRAL & CONSULTATION Patient Name:Date: Patient Phone:Patient DOB: Diagnosis: Request:PT Evaluate and Reevaluation Only RehabFrequency:Duration:
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Special services and mental refer to additional support and resources provided for individuals with mental health needs, ensuring they receive appropriate care and assistance.
Individuals or organizations that provide mental health services or support programs are typically required to file for special services and mental.
To fill out special services and mental, one must complete the designated forms available from the relevant authority, providing accurate information about the services provided and the targeted population.
The purpose of special services and mental is to enhance the quality of mental health care and ensure that individuals with mental health issues receive necessary support and interventions.
Information reported typically includes details about the type of services offered, the target demographic, funding sources, and outcomes achieved.
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