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Supportive Recovery Program Referral Package Checklist Please ensure all sections of this referral package are completed in entirety and submitted together to intake@thresholdhousing.ca. Date: Youth
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How to fill out central addiction intake referal

01
Gather necessary personal information such as name, address, and contact details.
02
Collect medical history, including any previous treatments for addiction.
03
Complete the section on substance use history, specifying types of substances used and duration.
04
Provide information on any co-occurring mental health disorders if applicable.
05
Fill out the consent and confidentiality agreement sections carefully.
06
Review the form for completeness and accuracy before submission.
07
Submit the completed intake referral form to the appropriate healthcare provider or facility.

Who needs central addiction intake referal?

01
Individuals struggling with substance abuse or addiction.
02
People seeking help for mental health issues related to addiction.
03
Family members or friends of individuals who may need assistance with addiction.
04
Individuals who have previously been treated for addiction and are seeking further support.
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Central addiction intake referral is a process that facilitates the assessment and treatment of individuals with substance use disorders by directing them to appropriate care resources.
Individuals seeking treatment for substance use disorders, as well as healthcare providers and organizations referring patients, are required to file a central addiction intake referral.
To fill out a central addiction intake referral, provide the necessary patient information, details about the substance use history, and any prior treatment received, ensuring all sections are completed accurately.
The purpose of central addiction intake referral is to streamline the treatment process for individuals with substance use disorders by ensuring they receive timely and appropriate care from specialized providers.
Required information includes the individual's personal details, substance use history, psychiatric evaluations if applicable, and any previous treatment information or referrals.
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