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Clermont County Wraparound Referral PacketDate: ___ Date of BirthIdentified Youths NameEducation Placement (Check One)AdoptedSchoolY or NRegular SchoolHome InstructionHearing ImpairedDropped OutPHAlternative
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How to fill out wraparound review committee referral

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How to fill out wraparound review committee referral

01
Obtain a referral form from the Wraparound Facilitator or Case Manager.
02
Fill out the client's information including name, DOB, address, and contact information.
03
Provide a detailed summary of the client's current situation, challenges, and needs.
04
List the goals and objectives for the client, including desired outcomes.
05
Include any relevant background information or documentation to support the referral.

Who needs wraparound review committee referral?

01
Individuals who require intensive and individualized support services.
02
Clients who are struggling to meet their goals and need a comprehensive team approach to address their needs.
03
Families or individuals who have complex needs that cannot be adequately met through traditional services.
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A wraparound review committee referral is a process used to gather a multidisciplinary team to assess and coordinate services for individuals who require comprehensive support due to complex needs.
Individuals or service providers who are seeking coordinated services for clients with complex needs are typically required to file a wraparound review committee referral.
To fill out a wraparound review committee referral, gather all necessary information about the individual, including personal details, specific needs, and any relevant background, then complete the referral form with this information.
The purpose of the wraparound review committee referral is to ensure that individuals receive comprehensive, tailored support through collaborative efforts among various service providers.
The referral must report personal details such as the individual’s name, contact information, specific needs, a summary of previous services, and any relevant medical or psychological history.
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