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CENTRAL ADDICTION INTAKE REFERRAL PACKAGE for

CENTRAL ADDICTION INTAKE REFERRAL PACKAGE for 2025

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The document is a Central Addiction Intake Referral Package from Vancouver Coastal Health, designed for individuals seeking admission to Supportive Transitional Living Residences (STLRs) and treatment facilities. It includes sections for client information, cultural background, substance use history, mental health concerns, and consent for information sharing. The package aims to gather comprehensive details about the client's needs and circumstances to facilitate appropriate care and support during their treatment journey.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Date of Referral' and 'Date of Birth' in the designated fields. Ensure accuracy as this information is crucial for processing.
Fill out the 'Client’s Community Health Authority' section by selecting the appropriate option from the list provided.
In the 'Program You are Referring To' section, select either STLRs or Treatment Facilities based on your referral needs.
Complete the 'CLIENT INFORMATION' section with details such as legal name, preferred name, and contact information. Be sure to indicate if it's okay to leave a message.
Proceed to fill out the 'CULTURAL INFORMATION' and 'CLIENT’S STRENGTHS, INTERESTS, HOPES' sections, providing any relevant details that may assist in treatment.
Continue through each section methodically, ensuring all required fields are completed accurately before submitting your form.

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