CHOICE INTEGRATED HEALTHCARE INC
3350 N Arizona Ave., Suite #2, Chandler, AZ 85225
Phone: 480-656-5374
Fax: 480-546-4536
Email: admin@choiceihc.org
Website: choiceihc.org
SELF-REFERRAL / GUARDIAN REFERRAL FORM
Members of conflict-affected populations can face a wide range of issues beyond those that agencies they are directly in contact with can address. Organizations can identify issues at individual or community level that are not directly covered through their own programmers or mandate. Staff, frontline workers and community members are sources of information on services available and can help persons of concern to access the services they need. A referral is the process of directing a potential member to another service provider because she/he requires help that is beyond the expertise or scope of work of the current service provider.
CHOICE INTEGRATED HEALTHCARE INC - OUTPATIENT SERVICES |
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Guiding Principles for Inter-Agency Referrals
In order for a referral not to create harm to the individual/community in need of assistance, the referral needs to respect at all times the following principles:
- Confidentiality: The principle of confidentiality requires all parties involved, volunteers, and community members to protect information disclosed or gathered in relation to any individual and to ensure that information is made accessible to a third party (i.e. service providers) only with the individual’s explicit permission.
- Consent: Referrals should only take place once the individual has given their informed consent. The individual has the right to limit information s/he wishes to disclose and persons with whom information will be shared.
- Respect the individual: Our partnership seeks to provide information about services available, in order for them to make a free and informed choice. Our agency commits to ensuring members are treated with dignity, decision-making capacities and preferences. You are not supposed to express your opinion, pass judgment or blame the individual.