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SOUTHERN UTE INDIAN TRIBE Southern Ute Health Center ATTN: Behavioral Health P.O. Box 899 Ignacio, CO 81137 REFERRAL FORM Date: Name of Person being referred: DOB: Contact Information:Referring Agency/Person:
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How to fill out behavioral health po box
How to fill out behavioral health po box
01
Obtain the behavioral health PO Box form from the respective agency or organization.
02
Fill out your personal information including name, address, contact number, and any other requested details.
03
Provide information about your behavioral health concerns or issues that you would like assistance with.
04
Sign and date the form as required.
05
Submit the completed form to the designated PO Box address.
Who needs behavioral health po box?
01
Individuals seeking behavioral health services or assistance
02
People experiencing mental health challenges
03
Patients in need of therapy or counseling
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What is behavioral health po box?
Behavioral health PO Box is a designated mailing address for submitting relevant forms, documents, or information related to behavioral health services or programs.
Who is required to file behavioral health po box?
Entities or individuals involved in providing behavioral health services or programs may be required to file information to the behavioral health PO Box as per regulations or guidelines.
How to fill out behavioral health po box?
To fill out the behavioral health PO Box, relevant forms or documents must be completed accurately and submitted through mail to the designated address.
What is the purpose of behavioral health po box?
The purpose of behavioral health PO Box is to centralize the collection of information related to behavioral health services or programs for tracking, monitoring, or compliance purposes.
What information must be reported on behavioral health po box?
The information to be reported on the behavioral health PO Box may include details of services provided, client demographics, program outcomes, funding sources, or other relevant data.
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