Get Therapeutic Behavioral Services (tbs)

Completing the Therapeutic Behavioral Services (TBS) referral form online can be straightforward with the right guidance. This document provides clear instructions to help you through each section, ensuring a comprehensive submission.

Follow the steps to successfully complete the TBS referral form.

1. Begin by locating and pressing the 'Get Form' button to access the THERAPEUTIC BEHAVIORAL SERVICES (TBS) referral form and open it in your preferred online editor.
2. In the first section, provide the youth's name, date of birth, and current address. Make sure to complete all required fields marked with an asterisk (*).
3. Input information regarding the youth's school and school district. This information is vital for context in the referral process.
4. Fill in the parent or caregiver's name and phone number. This is important for communication regarding the referral.
5. As the referring party, enter your name, agency, and your relationship to the youth. Ensure that you also provide your email, fax number, and phone number.
6. If applicable, provide details for the therapist involved, following the same procedure as the referring party. If the therapist is the same, you can leave this blank.
7. Indicate whether Child Welfare Services (CWS) is involved with a simple Yes or No, and complete the additional contact information if necessary.
8. List any other persons involved, such as CASA, mentors, attorneys, or probation officers, along with their contact information.
9. Indicate if the youth is a full scope Medi-Cal beneficiary under age 21 by selecting Yes or No. Provide the Medi-Cal number if applicable.
10. State whether the youth is receiving specialty mental health services from a therapist or intensive case manager by answering Yes or No.
11. Select which conditions have been met by the youth relevant to their current situation, ensuring that at least one box is checked.
12. Determine if the youth meets eligibility criteria for TBS by selecting the applicable options, ensuring at least one option is checked.
13. Describe specific behaviors that may jeopardize the youth's current living situation in detail. This section is crucial for understanding the need for TBS.
14. If there are specific requests regarding the TBS Coach, such as language or cultural preferences, provide that information.
15. Attach a Release of Information as instructed, ensuring all required sections are completed thoroughly.
16. Once the form is complete, you can save your changes, download, print for your records, or share the completed referral packet as needed.

Complete your THERAPEUTIC BEHAVIORAL SERVICES referral form online today for streamlined processing.