Get First Link Referral Form - Alzheimer Society Of Toronto - Alz

The First Link Referral Form is an essential document for individuals seeking support for dementia care in Toronto. This guide provides a detailed, step-by-step approach to filling out the form online, ensuring that users understand each component and its requirements.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the First Link Referral Form and open it in your preferred document editor.
2. Enter the date at the top of the form to establish when the request is being made.
3. Fill in the 'Person with Dementia' section by providing the name and diagnosis of the individual affected by dementia.
4. Indicate the living situation of the person with dementia by selecting one of the following options: 'With a caregiver,' 'Alone,' or 'In a residential facility.'
5. In the 'Caregiver / Contact' section, provide the name and relationship of the caregiver or contact person, ensuring clarity.
6. Choose the preferred language of both the person with dementia and the caregiver for effective communication.
7. Select the preferred method of contact, indicating whether the caregiver or person with dementia prefers to be contacted by phone or email, and specify a timeline for follow-up.
8. Confirm whether the contact has given permission to be contacted by the Alzheimer Society of Toronto and if it is acceptable to leave a voice message.
9. Select the services required, such as counselling, support groups, education, or other options as applicable.
10. Provide any additional information that may help the Alzheimer Society understand the needs of the person with dementia.
11. Complete the 'Referral Source Information' section by providing your name, agency, contact details, and follow-up preference.
12. Ask the patient or client to rate their confidence and stress regarding their caregiving role on a scale of 0 to 10.
13. Review all entered information for accuracy and completeness before proceeding.
14. Save any changes made to the document, and choose to download, print, or share the form as necessary.

Complete your First Link Referral Form online today to access the support you need.