Get Tbs San Diego Referral Forms

Filling out the Tbs San Diego Referral Forms can seem daunting, but this guide will walk you through each step in a clear and supportive manner. Whether you are a parent, caregiver, or referring party, you will find detailed instructions to complete the form accurately.

Follow the steps to fill out the Tbs San Diego Referral Forms online.

1. Press the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Fill in the date at the top of the form. Make sure to write the current date when completing the referral.
3. Enter the client’s name, date of birth (DOB), current address, and phone number in the specified fields.
4. Provide the name of the parent or caregiver, followed by the referring party's name and their contact phone number.
5. If applicable, check off any relevant agencies involved, such as ERMHS, CWS, or Probation.
6. List the case manager's name and phone number, ensuring you provide the details for both if there are multiple case managers.
7. Indicate whether the child/youth is a full scope Medi-Cal beneficiary under age 21 by selecting 'YES' or 'NO.' If 'YES,' include the Medi-Cal number.
8. Note if the child or youth is receiving Specialty Mental Health Services by filling in the current therapist or case manager's information.
9. Provide details on whether the therapist or case manager has been contacted regarding TBS and include the Axis I diagnosis code.
10. Check all applicable conditions that have been met by the child/youth as outlined in Section III.
11. Describe the specific problem behaviors jeopardizing the current living situation in the designated field.
12. If there are any specific needs concerning language, culture, or gender for the TBS coach, please specify in Section V.
13. Verify that the required TBS release paperwork is attached, including the signed authorization to disclose information and consent for treatment.
14. Review the entire form for accuracy and completeness before saving your changes.
15. After finishing, download or print a copy of the filled form and submit it via fax to Therapeutic Behavioral Services or mail it to the provided address.

Complete your Tbs San Diego Referral Forms online to ensure timely support for your needs.