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MENTAL HEALTH & SUBSTANCE USE INTAKE REFERRAL FORM (FOR PATIENTS 19+) PLEASE PRINT LEGIBLY FAX all pages either to Victoria CARES 2503813222 or Westshore CARES 2503705724. PATIENT INFORMATION if this

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Download the mhsu-referral-form-victoria.pdf from the appropriate website.

02

Open the PDF file using a PDF reader on your computer or mobile device.

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Fill in the required information in the designated fields, such as patient's name, contact information, referral reason, etc.

04

Make sure all information provided is accurate and up-to-date.

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Save the completed form to your device or print it out if necessary.

Who needs mhsu-referral-form-victoriapdf?

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Healthcare professionals who are referring a patient to mental health and substance use services in Victoria.

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What is mhsu-referral-form-victoriapdf?

The mhsu-referral-form-victoriapdf is a referral form used in the mental health and substance use system in Victoria.

Who is required to file mhsu-referral-form-victoriapdf?

Healthcare providers and organizations involved in mental health and substance use treatment are required to file the mhsu-referral-form-victoriapdf.

How to fill out mhsu-referral-form-victoriapdf?

The mhsu-referral-form-victoriapdf can be filled out online or in paper form, following the instructions provided on the form.

What is the purpose of mhsu-referral-form-victoriapdf?

The purpose of the mhsu-referral-form-victoriapdf is to refer individuals to appropriate mental health and substance use services in Victoria.

What information must be reported on mhsu-referral-form-victoriapdf?

The mhsu-referral-form-victoriapdf typically requires information such as the patient's demographics, previous treatment history, current symptoms, and the reason for referral.

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