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Click ‘Get Form’ to open the we care referral in the editor.
Begin by entering the date at the top of the form. This helps track when the referral was made.
Fill in the patient’s name and date of birth. Ensure accuracy for proper identification.
Provide the mailing address, city, and zip code. If there is a different physical address, include that as well.
Enter the phone number and an alternate contact with their phone number for follow-up purposes.
Indicate the language spoken by checking the appropriate box.
Answer questions regarding disability cases and health insurance status by selecting 'Yes' or 'No'.
Select one specialty from the list provided for which you are referring the patient.
Clearly state the reason for consultation in detail to ensure proper understanding of needs.
Include any required supporting documents such as office notes or lab results before submitting.
Finally, have the referring physician sign and print their name, along with providing a contact person’s details.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (95 Votes)
2017	4.4 Satisfied (53 Votes)
2014	4.3 Satisfied (48 Votes)

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What does we care stand for at VA?

WeCare, a nonprofit organization that provides comprehensive care to our healthcare professionals who are silently suffering from burnout, secondary trauma, and PTSD. We do this by providing wellbeing boxes, wellness conferences, immersive self-care retreats, and holistic membership opportunities.

What is the VA I care acronym?

VA had roughly 484,000 employees on Jan. 1, 2025, and 467,000 employees as of June 1, 2025 a reduction of nearly 17,000. Between now and Sept. 30, the department expects nearly 12,000 additional VA employees to exit through normal attrition, voluntary early retirement authority ) or the deferred resignation program.

What is a we care clinical assessment?

WeCare is a 10-item questionnaire assessing needs in 4 domains (economic stability, education, neighborhood physical environment, and food). Improving the management of family psychosocial problems at low-income childrens well-child care visits: the WE CARE Project.

What are wecare behaviors in the VA?

VA CORE VALUES Taking the first letter of each word Integrity, Commitment, Advocacy, Respect, Excellence creates a powerful acronym, I CARE, that reminds each VA employee of the importance of their role in this Department.

What is the meaning of WeCare?

The Wellness Comprehensive Assessment Rehabilitation and Employment (WeCARE) program provides clinical assessment, employment, Social Security application, wellness, and rehabilitation services to tens of thousands of New York City residents who receive public assistance and have physical and/or mental health