Get Referral Form:peer Options Program - Canadian Mental Health ... - Calgary Cmha

Filling out the Referral Form for the Peer Options Program is the first step in accessing important mental health support. This guide provides clear instructions on each section of the form to help users navigate the process with ease.

Follow the steps to complete the referral form online.

1. Click ‘Get Form’ button to download the Referral Form and open it in your preferred document editor.
2. Begin by entering the referral date, ensuring you select the correct day, month, and year.
3. Fill in your name in the designated space provided for personal identification.
4. Enter your date of birth by selecting the correct day, month, and year in the respective fields.
5. Indicate your gender by checking the appropriate box for either male or female.
6. Provide your mailing address, including street address and postal code, to ensure communication can be established.
7. List your contact numbers, including your home and cell phone numbers for further correspondence.
8. Optionally, you may provide your email address for confirmation of your referral processing.
9. Indicate whether you permit leaving a voicemail message by marking 'Yes' or 'No.'
10. Describe your cultural background and specify your primary language for better service accessibility.
11. Indicate your income source, selecting from the provided income brackets to give insight into your financial situation.
12. Provide information about any group experiences you've had in the past year to tailor support effectively.
13. Select the referral source that best represents how you found out about the program, marking your choice.
14. Detail your mental health issues or disorders to give the program an understanding of your needs.
15. Include any additional information about health issues, mobility, or other support needs to improve assistance.
16. Complete the referral contact section by inputting the name, telephone number, and email address of your therapist or support worker.
17. Ensure all data is correctly filled in before saving your changes, downloading, printing, or sharing the form as needed.

Start completing your Referral Form online today for access to essential mental health support.