Get Phoenix Center Adol 014 2019

The Phoenix Center Adolescent Referral Form is an essential document for individuals seeking assessment services. This guide provides clear and systematic instructions on how to accurately complete the form online, ensuring a smooth application process.

Follow the steps to fill out the Phoenix Center ADOL 014 online effectively.

1. Press the ‘Get Form’ button to access the document and open it in your preferred online editing tool.
2. Enter the date of referral in the designated field at the top of the form.
3. Fill in the client’s name, followed by their Social Security number (SS#) in the respective fields.
4. Provide the parent or guardian's name in the designated area, followed by the phone number for contact.
5. Indicate the referring agency name in the specified field.
6. Select the reasons for referral by checking the appropriate boxes next to the recommended services such as AOD Assessment, Behavioral Health Assessment, Anger Management, Why Try Program, and Drug Screen.
7. Note that you will need to call to schedule your appointment at The Phoenix Center, available from Monday to Friday, and ensure to mention that you will present this form upon arrival.
8. In the section regarding what to bring, list the required items: photo identification, parent or legal guardian accompaniment if under 16, Medicaid and/or insurance cards, and Social Security card.
9. If applicable, confirm the dates for the drug test and the fees required for different screening options.
10. Review all filled sections for accuracy before proceeding to save your changes, download the form, print it, or share it as needed.

Complete your Phoenix Center ADOL 014 form online today to ensure timely processing of your referral.