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MEDICALLEGAL PARTNERSHIP REFERRAL FORM: COMPLEX Rename of Referring Health Care Provider: Email and/or Phone Number of Referring Health Care Provider: Today's Date:1. Identify the Problem for Which
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Gather all necessary documents and information related to the case
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Schedule an appointment with a medical-legal partnership provider
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Follow up with the provider as needed to ensure the case is progressing

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Individuals who are facing legal issues that are impacting their health or well-being
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People who are in need of legal assistance but may not have the resources to hire a lawyer on their own
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Patients who have been referred by a healthcare provider or social worker for legal assistance
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Medical-legal partnership is powerful because it addresses social determinants of health by combining medical and legal expertise to address underlying causes of health disparities.
Medical-legal partnership can be filed by healthcare providers, legal professionals, social workers, and community organizations.
To fill out medical-legal partnership, one must gather information on the patient's health issues and legal needs, collaborate with the necessary professionals, and document the interventions and outcomes.
The purpose of medical-legal partnership is to improve health outcomes by addressing the social and legal factors that impact a patient's well-being.
Information such as the patient's health issues, legal needs, interventions taken, outcomes achieved, and any barriers encountered must be reported on medical-legal partnership.
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