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  • Universal Referral Form (urf) And Application - Nyc.gov - Nyc

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Your referral, NYC Department of Health and Mental Hygiene (DOHMH) New York City's Adult Single Point of Access (SPOA) program .... The Universal Referral Form (URF) including SPOA Coversheet.

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How to fill out the Universal Referral Form (URF) and Application - NYC.gov - NYC online

This guide provides step-by-step instructions for users looking to successfully complete the Universal Referral Form (URF) and Application. Clear guidance is offered to ensure a smooth online filing process.

Follow the steps to fill out the Universal Referral Form effectively.

  1. Press the ‘Get Form’ button to access the Universal Referral Form, which will open in your document editor.
  2. Begin with the date of submission at the top of the form. Fill in the current date as accurately as possible.
  3. Complete the 'From:' section with the referring agency or program details. This includes the name of the worker, contact phone number, and email address.
  4. In the 'To:' section, ensure you include all necessary documents along with the URF as specified, including the cover sheet and any required consent forms.
  5. Move on to the applicant's information section. Fill out the applicant's name, date of birth, and select the preferred level of service requested by checking the appropriate box.
  6. Provide detailed demographic information, including the borough of residence and the primary language spoken by the applicant.
  7. Include the applicant’s contacts for emergencies in the family contacts section, including name, relationship, and contact information.
  8. Complete the clinical and characteristics sections thoroughly, including any prior treatments, current medications, and living situation details.
  9. In the referral source section, state where the referral originated from and fill out the referring agency's information accurately.
  10. After completing all sections, review the form for accuracy. Ensure all known fields are filled, and indicate if any information is unknown or not applicable.
  11. Save your changes, and download a copy if necessary. You can also choose to print or share the completed form as required.

Ensure to complete the filing of the Universal Referral Form online to facilitate efficient processing.

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Contact support

Parents are encouraged to call 311 and ask for Early Intervention to make referrals. Administration for Children's Services (ACS) employees and agencies contracted with ACS must call the Citywide ACS Referral Hotline at 877-885-KIDZ (877-885-5439) to make referrals.

Early childhood intervention (ECI) is a support and educational system for very young children (aged birth to six years) who have been victims of, or who are at high risk for child abuse and/or neglect as well as children who have developmental delays or disabilities.

The Early Intervention Program helps young children (birth to 3 years) who are not learning, playing, growing, talking or walking like other children their age. The program works with your family to set meaningful goals for your child and create a service plan to help your child and your family meet those goals.

All contracted individuals and all contracted agencies MUST be approved by the New York State Department of Health Early Intervention Program to deliver early intervention services.

Children's Single Point of Access (CSPOA) is a centralized referral system for children and youth with serious emotional disturbance who need intensive mental health services to remain at home or in their community.

Who makes the referral for early intervention services? Anyone can make a referral, including parents, medical care providers, neighbors, family members, foster parents, and day care providers. The first step that parents may take is to discuss their concerns with their health care provider/doctor.

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