Get the free Universal Referral FormLighthouse Recovery Community Center

Universal Referral Form Consumer/Service Recipient Name: Telephone: Secondary form of contact: Date of Birth://Gender (optional): FM Others Would rather not discloseAddress: County of Residence: Date:

How to fill out universal referral formlighthouse recovery

How to fill out universal referral formlighthouse recovery

1. To fill out the universal referral form for Lighthouse Recovery, follow these steps:
2. Start by downloading the universal referral form from the official Lighthouse Recovery website.
3. Open the form using a compatible PDF reader.
4. Fill in the required personal information of the individual being referred, such as full name, contact details, mailing address, and date of birth.
5. Provide relevant details about the individual's current situation, including any specific concerns or reasons for referral.
6. Indicate the preferred contact method and any additional information or notes that may be helpful for Lighthouse Recovery.
7. Review the completed form to ensure all information is accurate and complete.
8. Save the filled out form.
9. Depending on the instructions provided on the website, either submit the form electronically or print it out and submit it via mail or in person to Lighthouse Recovery.
10. If submitting electronically, attach the saved form file to the designated email or online submission portal.
11. If submitting via mail or in person, ensure the form reaches the appropriate office or location of Lighthouse Recovery.
12. Await response or further instructions from Lighthouse Recovery regarding the referral.

Who needs universal referral formlighthouse recovery?

1. Universal referral form from Lighthouse Recovery is needed by individuals or organizations who wish to refer someone to Lighthouse Recovery for addiction or mental health treatment.
2. This form allows professionals, friends, family members, or concerned parties to officially request Lighthouse Recovery's intervention and support for individuals who may benefit from their services.
3. It is typically used for referrals related to substance abuse, addiction, or mental health concerns.
4. Anyone who believes that someone they know or work with can benefit from Lighthouse Recovery's expertise and resources can utilize this universal referral form.

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What is universal referral formlighthouse recovery?

Universal referral formlighthouse recovery is a form used to refer individuals to the lighthouse recovery program for addiction treatment.

Who is required to file universal referral formlighthouse recovery?

Healthcare providers, social workers, and other professionals who work with individuals struggling with addiction are required to file the universal referral form for lighthouse recovery.

How to fill out universal referral formlighthouse recovery?

The universal referral form for lighthouse recovery should be completed with the individual's personal information, details of the addiction issue, and any relevant medical history.

What is the purpose of universal referral formlighthouse recovery?

The purpose of the universal referral form for lighthouse recovery is to connect individuals struggling with addiction to the lighthouse recovery program for support and treatment.

What information must be reported on universal referral formlighthouse recovery?

The universal referral form for lighthouse recovery must include the individual's name, contact information, details of the addiction issue, medical history, and any relevant notes or observations.