Get Osu Referral Form

The Osu Referral Form is an essential document for initiating the intake assessment for the Adult Partial Hospitalization Program at Osu Harding Hospital. This guide will help you navigate the form's components step-by-step, ensuring that you complete it accurately and efficiently.

Follow the steps to complete the Osu Referral Form online

1. Click the ‘Get Form’ button to access the Osu Referral Form and open it in the online editor.
2. Begin by filling in the patient’s name. This is a crucial identifier and must be accurate.
3. Next, enter the patient’s address. This information is necessary for further communication and should include the complete details.
4. Provide the patient's phone number. Ensure this is a current contact number.
5. Enter the patient's insurance information. This is important for processing and verifying coverage.
6. Identify the referral source by filling in the name and providing a contact phone number and fax number of the referring individual or organization.
7. Clearly state the reason for the referral. This section gives context to the referral and aids in appropriate assessment.
8. Document the date when the patient was last seen by their provider. This helps in understanding the current context of care.
9. Complete the Axis I, II, III, and IV sections, which capture relevant diagnostic and psychosocial information.
10. Indicate the patient's current Global Assessment of Functioning (GAF) score, as well as the highest GAF score within the past year, if known.
11. Include any other relevant clinical information, which may encompass current medications the patient is taking, to provide a comprehensive view.
12. Once all fields are complete, you can save changes to the form, download it for your records, print a copy, or share it with the relevant parties as required.

Complete the Osu Referral Form online today to ensure timely assessment and support for those in need.