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COMMUNITY SPECIALIZED SERVICES, INC. SCREENING/REFERRAL FOR SERVICES Date of Referral:___ Date Service Needed:___ County of Residence :___ Service Requested:___B3 Respite ___Therapeutic Foster Care

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Obtain the CSSI referral formdoc from the appropriate department or website.

02

Fill out all required fields on the form, such as personal information and reason for referral.

03

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04

Review the form for accuracy and completeness before submission.

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Submit the completed form according to the instructions provided.

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What is cssireferral formdoc?

cssireferral formdoc is a form used to report referrals to the CSSI.

Who is required to file cssireferral formdoc?

Any entity or individual who refers a potential violator to the CSSI.

How to fill out cssireferral formdoc?

You can fill out cssireferral formdoc online or by submitting a paper form to the CSSI.

What is the purpose of cssireferral formdoc?

The purpose of cssireferral formdoc is to report potential violators to the CSSI for further investigation and possible enforcement action.

What information must be reported on cssireferral formdoc?

You must report information such as the violator's name, contact information, description of the violation, and any supporting evidence.

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