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Bridgeway Rehabilitation Services Fax # : 973-383-8676 93

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The document is a referral form for Bridgeway Rehabilitation Services, specifically for the Community Support Team in Sussex, NJ. It collects essential information about individuals being referred for various mental health services, including case management, supported housing, and employment support. The form requires details such as personal information, reasons for referral, diagnoses, current medications, and any relevant medical or psychiatric history. It also outlines the necessary records to be included with the referral and provides sections for internal use regarding service requests and follow-up.

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