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What is Nassau County Mental Health Referral Form about?

This document is a referral form for care coordination and assistance services in Nassau County, New York. It collects identifying and contact information for the individual being referred, including name, address, phone, insurance/entitlements, and demographic data. Clinical information includes psychiatric diagnoses, medical conditions, and current treatment providers. The form determines appropriateness for health home services based on risk factors and needs. For assisted outpatient treatment (AOT) refe

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api-280373607

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EN