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SAMPLE INTERAGENCY REFERRAL AGREEMENT This document serves as an agreement between Superior Court Alcohol and Drug Program and (Treatment Provider) regarding referrals of court ordered offenders to

How to fill out interagency referral agreement

How to fill out interagency referral agreement:

1. Download a template or obtain a physical copy of an interagency referral agreement form.
2. Read the instructions provided with the form to familiarize yourself with the requirements and purpose of the agreement.
3. Fill in the necessary details in the agreement, such as the names and contact information of the parties involved (agencies or individuals), the purpose of the referral, and any specific terms or conditions.
4. Provide a clear and concise description of the services or resources being referred, including any relevant deadlines or limitations.
5. Review the agreement carefully to ensure all information is accurate and complete.
6. If required, obtain any necessary signatures from the authorized representatives of each party involved.
7. Make copies of the filled-out agreement for all parties involved, keeping one for your records and distributing the others as necessary.

Who needs interagency referral agreement:

1. Professionals working in government agencies or departments that interact or collaborate with other agencies in providing services or resources.
2. Social service organizations, nonprofit organizations, or community-based organizations that engage in partnerships or collaborations with other agencies or entities.
3. Private businesses or individuals who frequently refer clients, customers, or patients to other organizations for specialized services or resources.

For pdfFiller’s FAQs

What is interagency referral agreement?

An interagency referral agreement is a formal agreement between two or more agencies to refer clients to each other for services.

Who is required to file interagency referral agreement?

Any agencies or organizations that work together to provide services to clients may be required to file an interagency referral agreement.

How to fill out interagency referral agreement?

To fill out an interagency referral agreement, agencies must provide information about the services they offer, the clients they serve, and the process for making referrals.

What is the purpose of interagency referral agreement?

The purpose of an interagency referral agreement is to ensure that clients receive the services they need in a coordinated and efficient manner.

What information must be reported on interagency referral agreement?

Information such as the names of the agencies involved, the services offered, the target population, and the referral process must be reported on the interagency referral agreement.

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