Get Community Mental Health Program Application Form

This guide provides comprehensive instructions on how to complete the Community Mental Health Program Application Form online. Following these steps will help ensure that your application is filled out accurately and submitted effectively.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the date of application. Indicate the day, month, and year accurately in the provided space.
3. Provide information regarding the applicant's awareness of the application. If the applicant is not aware, you must explain the reason in the designated space.
4. Complete the applicant information section. Include the last name, first name, initial, address, postal code, date of birth, relationship status, employment status, source of income, financial management details, and any relevant health identification numbers.
5. If applicable, fill out the referral source section with the name of the referral source, organization, and contact information. Include all relevant options based on the individual's situation.
6. In the personal information contacts section, provide names and contact details for the next of kin or contact persons, as well as any other involved agencies.
7. Answer the questions related to previous involvement in mental health programs, reasons for requesting services, and current difficulties being experienced.
8. Detail any mental health diagnoses if applicable, and information about past hospitalizations or risks related to self-harm or other risks.
9. Complete the sections addressing substance use, housing status, use of crisis services, social supports, and any cross-cultural concerns.
10. Identify any multi-system involvement or professional supports that are currently engaged, and specify the program preferences based on the applicant's needs.
11. Conclude by signing the application as both the applicant and the referral source if applicable.
12. After completing all sections, review your entries for accuracy. Save any changes, and proceed to save, download, print, or share the completed form as needed.

Take the next step towards receiving support by completing your Community Mental Health Program Application Form online today.