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Referral Form
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referrals@lumicaretech.comContact Us:
A : 1996 Ewing's Mill Rd, Acropolis, PA 15108
P:8773812209E : contact@lumicaretech.comREFERRAL CONTACT PERSON
Name of Contact:
Title/Role
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How to fill out substance outpatient services referral
How to fill out substance outpatient services referral
01
Contact the substance outpatient services provider to request a referral form.
02
Fill out the referral form with the client's personal information, including name, date of birth, contact information, and reason for referral.
03
Provide any additional relevant information about the client's substance use history, treatment goals, and current mental health status.
04
Submit the completed referral form to the substance outpatient services provider for review and approval.
Who needs substance outpatient services referral?
01
Individuals who are struggling with substance abuse or addiction and are seeking outpatient treatment services.
02
Individuals who have been referred by a healthcare professional, therapist, or other treatment provider for substance abuse treatment.
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What is substance outpatient services referral?
Substance outpatient services referral is a formal process by which a healthcare provider directs a patient to specialized outpatient services for the treatment of substance use disorders.
Who is required to file substance outpatient services referral?
Healthcare providers, typically those who diagnose substance use disorders, are required to file substance outpatient services referrals for their patients needing specialized treatment.
How to fill out substance outpatient services referral?
To fill out substance outpatient services referral, the provider needs to complete a designated form with patient information, diagnosis, recommended services, and any pertinent medical history.
What is the purpose of substance outpatient services referral?
The purpose of substance outpatient services referral is to ensure that individuals receive the appropriate level of care for their substance use issues, improving access to necessary treatment.
What information must be reported on substance outpatient services referral?
The information that must be reported includes patient demographics, diagnosis, treatment recommendations, and any relevant medical history or medications.
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