adult single point of access (aspoa) referral form EMAIL TO [email protected] OR FAX TO (315) 768-3670 SUBMISSION OF A SEPARATE MENTAL HEALTH ASSESSMENT OR PSYCHIATRIC EVALUATION IS REQUIRED IN ADDITION TO THIS REFERRAL FORM.

Oneida County Department of Mental Health operates a Single Point of Access & Accountability (SPOAA) for Adults, Children & Youth. The Adult Single Point of Access & Accountability (ASPOAA) is the process for referring adults to care management and/or residential services, and for monitoring the referral process within Oneida County.

(ASPOAA) Referral Form. Care Management and Residential Services . NAME: _____ DOB: _____ Before completing this referral, please ensure (and mark) the following: This individual is 18+ years old . This individual has a primary DSM-5 diagnosis of a severe mental

Begin your application on the SPOA referrals portal entry page and enter pertinent information. For questions related to a SPOA referral, email [email protected], or call 347-396-7258. The Center for Urban Community Services currently oversees the housing referral process.

Send or fax referral forms to: For general inquiries regarding A-SPOA, admission criteria for case management and residential programs, or referral status, please contact: Bianca Britton, A-SPOA Coordinator, at (315) (315) 777-9716 or [email protected].

Please review REQUIRED DOCUMENTATION FORM below. Referrals will not be considered complete without: Clinical Information as specified below. Do not send progress notes or treatment plans in lieu of psychosocial and psychiatric evaluation. Upon receipt, applications will be reviewed by DCMH for eligibility and completeness.

This form complies with the requirements of § 33.13 of the New York Mental Hygiene Law, federal alcohol and drug record privacy regulations (42 CFR Part 2), and federal law governing privacy of education records (FERPA) (20 USC 1232g).

Jul 19, 2021 · ASPOA – Authority on Special Power of Attorney by Tax Practitioner To be completed by a tax practitioner to further delegate an employee to act on a client’s behalf (The TPPOA must be submitted simultaneously with this ASPOA to SARS offices)

The SARS Authority on Special Power of Attorney by Tax Practitioner (ASPOA) form must be completed by a tax practitioner to authorise an employee to act on the client’s behalf. The TPPOA form must be submitted together with the ASPOA to SARS offices.

Following this page you will find information on the ASPOA description of services, application guide, criteria for referral, and application for services. If you are requesting services for yourself and completing the application , please do your best to fill in all sections.