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REFERRAL Reassessment and Admissions Department 1955 West Truckers Drive Fayetteville Arkansas 72704 4799736000 office, 4795715390 mandates: ___ Treatment Program Requested: (circle one) o Inpatient
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How to fill out referral form-assessment and admissions
How to fill out referral form-assessment and admissions
01
Obtain a copy of the referral form for assessment and admissions.
02
Fill in all required personal and medical information accurately.
03
Provide any relevant supporting documents or referrals from other healthcare providers.
04
Submit the completed referral form to the appropriate department or facility for processing.
Who needs referral form-assessment and admissions?
01
Individuals who require specialized medical treatment or care.
02
Patients who have been recommended for a specific program or service by their healthcare provider.
03
Anyone seeking admission to a healthcare facility or program that requires a formal referral process.
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What is referral form-assessment and admissions?
The referral form-assessment and admissions is a document used to request assessment and admissions services for a specific individual.
Who is required to file referral form-assessment and admissions?
The person or organization responsible for the individual's care is required to file the referral form for assessment and admissions.
How to fill out referral form-assessment and admissions?
The referral form for assessment and admissions can be filled out online or in person by providing all required information about the individual in need of services.
What is the purpose of referral form-assessment and admissions?
The purpose of the referral form for assessment and admissions is to initiate the process of evaluating and admitting individuals to the appropriate care facilities.
What information must be reported on referral form-assessment and admissions?
The referral form for assessment and admissions must include the individual's personal information, medical history, and reason for seeking care services.
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