Get Tat Referral Form - Alameda County Behavioral Health - Acbhcs

Filling out the TAT Referral Form for Alameda County Behavioral Health can be a straightforward process if you follow the correct steps. This guide provides detailed instructions to help you complete the form accurately and efficiently, ensuring that all necessary information is included.

Follow the steps to complete the TAT Referral Form online.

1. Click ‘Get Form’ button to access the TAT Referral Form and open it in the designated editor.
2. Enter the client’s name, birth date, age, referral date, and the social security number in the respective fields. Ensure that the information is accurate and up-to-date.
3. Fill in the client's contact information, including address and phone number, to facilitate communication.
4. Provide your details as the referring individual, including your name, agency, phone number, and fax number.
5. In the section titled 'Why referring to TAT?', clearly outline the reason for the referral, detailing any relevant information that may assist in the client's care.
6. Document the client's current diagnosis and supporting symptoms by filling in all axes (I, II, III, IV, V) along with the Global Assessment of Functioning (GAF) score.
7. List all medications prescribed to the client and any compliance issues, followed by the name of the prescribing medical doctor and the date of the next appointment.
8. If applicable, describe the client's hospitalization history, including dates and reasons for hospitalization. Attach additional pages if more space is needed.
9. Detail any substance abuse history by specifying the drug of choice, duration of use, and any family history related to substance use.
10. Provide information regarding any self-harm history, as well as any criminal or violence history, if relevant.
11. Explain what has been done to assist the client in transitioning to adult mental health services.
12. Describe the client’s current living situation, including any concerns about future housing within the next six months.
13. Indicate the client's educational history and vocations goals, including any completed grades, certifications, or degrees.
14. Discuss any foster care experiences the client may have had, along with details surrounding their circumstances.
15. Assess the current level of social and intellectual functioning and evaluate daily living skills of the client.
16. Highlight the strengths, supports, and family involvement that can aid in the client's care.
17. Register the status of benefits and any applications for adult Supplemental Security Income (SSI), also noting whether the client has insurance.
18. Identify any involved agencies and resources that support the client, including housing and mental health services.
19. Convey the client's desires and needs, such as housing or vocational training, ensuring to mark all that apply.
20. Outline the current discharge plan for the client to ensure that appropriate follow-up action can be taken.
21. After completing all fields, review the form for accuracy. You may then save changes, download, print, or share the form as necessary.

Take the next step in supporting individuals in need by completing the TAT Referral Form online today.