Tool – Mental Health Referral and New Provider Inquiry Forms

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Icon for Mental Health and Wellness Resource Type

This tool includes a Mental Health Referral Form and a New Provider Inquiry Form that refugee service providers may use in collaboration with mental healthcare providers as they work to build a culturally informed referral network. The Mental Health Referral Form is designed to be completed by the caseworker/refugee service provider making the referral, then shared with the mental healthcare provider. The New Provider Inquiry Form is designed to be given to mental healthcare providers by refugee service providers as they enter into new referral partnerships. Mental healthcare providers may then complete the form and return it to refugee service providers.

Topic(s): Mental Health and Wellness
Subtopic(s):
Resource Type: Tool or Template
Date: June 11, 2019
Language(s): English
Target Audience(s): Service Provider
Author(s): Switchboard

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