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Cambridge Referral Form 640 Jackson Street, St. Paul, MN 55101 Phone: 6512542402 Fax: 6512546655 TODAYS DATE:Referring Agency Information Agency, Clinic, or Hospital: Inpatient Unit: Phone: Discharge

How to fill out mental health referral form

How to fill out mental health referral form

1. Gather necessary information such as personal information, insurance information, and reason for referral.
2. Contact the appropriate mental health provider or agency to request a referral form.
3. Fill out the form completely and accurately, providing detailed information about the individual's mental health needs.
4. Attach any supporting documentation, such as previous medical records or evaluations, if applicable.
5. Submit the completed form to the mental health provider or agency either in person, by mail, or electronically.

Who needs mental health referral form?

1. Individuals who are seeking mental health treatment from a specialized provider.
2. Individuals who have been recommended by their primary care physician or therapist to see a mental health specialist.
3. Individuals who are experiencing symptoms of a mental health condition and are in need of professional help.

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What is mental health referral form?

Mental health referral form is a document used to refer individuals to mental health services or professionals for assessment and treatment.

Who is required to file mental health referral form?

Healthcare professionals, social workers, and counselors are typically required to file mental health referral form.

How to fill out mental health referral form?

To fill out a mental health referral form, one must include the individual's personal information, reason for referral, any relevant medical history, and contact information for the referring party.

What is the purpose of mental health referral form?

The purpose of a mental health referral form is to connect individuals in need of mental health services with appropriate professionals or resources.

What information must be reported on mental health referral form?

Information that must be reported on a mental health referral form includes the individual's name, age, contact information, reason for referral, and any relevant medical or mental health history.