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Huron Perth Healthcare Alliance Eating Disorders Outreach Program Referral Form Information for Referral Source A referral from a Primary Care Provider (Physician or Nurse Practitioner) is required
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Obtain the 2023-04 eating disorders outreach form.
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Complete all required personal information, including name, contact information, and demographics.
03
Provide detailed information about the eating disorder outreach program you are participating in or organizing.
04
Clearly state the goals and objectives of the outreach program.
05
Include any relevant statistics or data to support the need for the program.
06
Submit the completed form to the designated recipient by the specified deadline.

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Individuals or organizations planning to conduct an eating disorders outreach program in 2023 would need the 2023-04 eating disorders outreach form.
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04 eating disorders outreach refers to a program or initiative aimed at raising awareness, providing support, and promoting education about eating disorders.
Anyone who is organizing or participating in an eating disorders outreach program may be required to file 04 eating disorders outreach.
To fill out 04 eating disorders outreach, you may need to provide information such as the name of the program, its objectives, target audience, activities, and outcomes.
The purpose of 04 eating disorders outreach is to help individuals affected by eating disorders, raise awareness in the community, and provide support and resources.
Information that must be reported on 04 eating disorders outreach may include program details, activities conducted, number of participants, impact assessment, and any collaborations with other organizations.
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