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Referral Form Adolescent Substance Abuse Treatment Programs 601 South Black Horse Pike Williams town, NJ 08094 594 Benson Street Camden, NJ 08103 Phone: 1.877.9.ACCESS Fax: 856.728.1407 Email: adolescentsubstanceabuse

How to fill out referral form adolescent substance

Point by point instructions on how to fill out a referral form for adolescent substance:

1. Start by identifying the purpose of the referral form. Determine if it is specifically for substance abuse in adolescents.
2. Familiarize yourself with the required information that needs to be filled out in the referral form. This may include details about the adolescent's personal information, substance abuse history, and any previous treatment experiences.
3. Ensure that all the necessary contact information is provided. This may include the adolescent's name, address, phone number, and emergency contact information.
4. Clearly indicate the reason for the referral and provide a detailed description of the adolescent's substance abuse issue. Include any relevant information about the duration and severity of the problem.
5. If applicable, provide information about any co-occurring mental health disorders that the adolescent may be experiencing. This can help professionals understand the full scope of their needs.
6. If the referral form includes a section for additional comments or observations, use this space to provide any relevant information that could assist in the assessment and treatment process.
7. Double-check all the information to ensure its accuracy and completeness. Any missing or incorrect information can delay the referral process.
8. Submit the referral form according to the designated instructions. This may involve mailing the form, emailing it to a specific contact, or submitting it through an online portal.

Who needs a referral form for adolescent substance?

1. Healthcare professionals: Doctors, pediatricians, psychiatrists, or therapists who suspect or diagnose substance abuse in adolescents may require a referral form to initiate specialized treatment.
2. Social workers: Social workers who work with adolescents and notice signs of substance abuse may need to fill out a referral form to connect them with appropriate services.
3. School counselors: School counselors who identify substance abuse problems among students may use referral forms to ensure the necessary support and intervention are provided.
4. Parents or guardians: Concerned parents or guardians who seek professional help for their adolescent's substance abuse may be required to fill out a referral form to initiate the assessment and treatment process.

Remember, accurately filling out a referral form is crucial in providing the necessary information to properly assess and address an adolescent's substance abuse issues.

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What is referral form adolescent substance?

The referral form for adolescent substance abuse is a document used to refer an adolescent to appropriate services for substance abuse treatment.

Who is required to file referral form adolescent substance?

Any individual or organization who becomes aware of an adolescent in need of substance abuse treatment is required to file the referral form.

How to fill out referral form adolescent substance?

To fill out the referral form for adolescent substance abuse, one must provide detailed information about the adolescent's behaviors, history of substance use, and any other relevant information.

What is the purpose of referral form adolescent substance?

The purpose of the referral form for adolescent substance abuse is to ensure that adolescents in need of substance abuse treatment receive the necessary support and services.

What information must be reported on referral form adolescent substance?

Information such as the adolescent's demographics, substance use history, behavioral patterns, and any previous treatment attempts must be reported on the referral form.