Get the free Peer Support Services Referral Form - Lancaster

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PFC Peer Support Center Referral Form Region: ___ Date of Referral: ___ Type of support requested: Adult Family Houseperson being referred___ Age___ Parent or caregiver Youth Adult Phone number___

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How to fill out peer support services referral

01

Obtain a peer support services referral form from a healthcare provider or organization.

02

Fill out your personal information, including name, contact information, and any relevant medical history.

03

Specify the reason for seeking peer support services and any goals or expectations you have for the referral.

04

Provide any additional information or context that may be helpful for the peer support provider.

05

Sign and date the referral form before submitting it to the designated recipient.

Who needs peer support services referral?

01

Individuals who are experiencing mental health challenges or emotional distress.

02

People who are looking for support from others who have gone through similar experiences.

03

Those who would benefit from peer-led interventions and guidance in their recovery journey.

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What is peer support services referral?

Peer support services referral is a process of connecting individuals with peer supporters who have gone through similar experiences to provide emotional and practical support.

Who is required to file peer support services referral?

Individuals who are in need of peer support services or those who are responsible for managing mental health programs are required to file peer support services referral.

How to fill out peer support services referral?

To fill out a peer support services referral, one must provide personal information, details of their mental health condition, and the type of peer support services needed.

What is the purpose of peer support services referral?

The purpose of peer support services referral is to ensure individuals receive appropriate support from peers who can relate to their experiences and provide valuable guidance.

What information must be reported on peer support services referral?

Information such as the individual's name, contact information, mental health diagnosis, preferred type of peer support, and any relevant medical history must be reported on a peer support services referral.

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