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CHO Dublin North City and County
School Aged Team (SAT) Referral/Screening Form
5 years 13 years 11 months1Office use only:
Date logged on database:
Date received:
Acknowledgement:___
___
___CHO
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How to fill out sadt referral intake form
How to fill out sadt referral intake form
01
Obtain a copy of the SADT referral intake form from the appropriate authorities or organization.
02
Fill in the personal information section, including name, date of birth, contact information, and any relevant identification details.
03
Provide details about the reason for the referral, including any medical conditions or services needed.
04
Include any pertinent medical history or previous treatment information.
05
Sign and date the form, ensuring all required fields are completed accurately.
06
Submit the completed form to the designated individual or department as instructed.
Who needs sadt referral intake form?
01
Individuals who require specialized assessment or treatment services from the Substance Abuse and Dual Diagnosis Treatment (SADT) program.
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What is sadt referral intake form?
The SADT referral intake form is a document used to refer individuals to Substance Abuse Disorder Treatment (SADT) services.
Who is required to file sadt referral intake form?
Healthcare providers, social workers, or other professionals who identify individuals in need of SADT services are required to file the SADT referral intake form.
How to fill out sadt referral intake form?
To fill out the SADT referral intake form, the referrer must provide detailed information about the individual in need of SADT services, including their demographics, substance abuse history, and treatment preferences.
What is the purpose of sadt referral intake form?
The purpose of the SADT referral intake form is to facilitate the referral process for individuals in need of SADT services and ensure they receive appropriate treatment.
What information must be reported on sadt referral intake form?
The SADT referral intake form must include information such as the individual's name, age, address, substance abuse history, current treatment providers, and any relevant medical conditions.
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