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PMENTAL DISABILITIES/SUBSTANCE ABUSE SERVICES Regional Referral Form for Admission to a State Psychiatric Hospital or ADATC Referral to: Referral made by: Regional Psychiatric Hospital Provider LME ADATC Self-Referral Other: Name of Referral Source/Agency: Contact #:( ) Consumer/Patient s Name: Last First Middle/Maiden Date of Birth: MM DD YY Other Names Used by Consumer (if.

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Related content

Regional Referral Form - NC.gov
NC DIVISION OF MENTAL HEALTH/DEVELOPMENTAL ... Regional Referral Form for Admission to a...
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Referral Information - UNC Center for Excellence...
For all new referrals, please use the appropriate referral form listed below, and fax to...
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North Carolina Palliative Care Resource Guide The University of North Carolina at ... NC...
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App20102 08 COMPANIES FORM No 411A Declaration Of Satisfaction V21 Cluster 2 Acute Care To Rehab Complex Continuing ORGANIZATION INFORMATION - Strathroy-caradocca

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A written order from your primary care doctor for you to see a specialist or get certain medical services. In many Health Maintenance Organizations (HMOs), you need to get a referral before you can get medical care from anyone except your primary care doctor.

There are four psychiatric hospitals: Broughton Hospital in Morganton, Central Regional Hospital in Butner, Cherry Hospital in Goldsboro, and Dorothea Dix Hospital in Raleigh.

The reason(s) for the patient requiring involvement with care professionals. These may include any problem, issue or event affecting the patient's health and/ or well being.

A regional referral center is a hospital or health system that is established to support a high volume of transferred patients in the region with complex Medical, Surgical and Trauma cases.

Referral service – A type of reference service in which an information seeker is directed to an agency or expert outside the library wherefrom the information may be obtained.

An effective referral system ensures that there is a close relationship among all levels of health care, and individuals can receive the best possible care. The main purpose of the present study was to summarize studies that have addressed factors affecting the successful implementation of the referral system.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232