№ lp_2_3_25463
File format: docx
Character count: 2145
File size: 120 KB
This document is a formal referral form used in the case management and judicial review process, containing client and referral details, charges, court information, and relevant health or custody factors.
Note:
Date
Document Type:
Referral Form
Price: 8 / 10 USD
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Document type:
Notice to practitioner
Division:
Criminal Division
Authorised by:
Anna Murru: Manager, Courts Integrated Services Program (CISP)
Version:
1.0
Date:
26/5/21
Author:
Jay Jordens: Senior Project Officer (CISP)
Summary of changes:
Document created
Note:
Eligibility Criteria
Report Completion Timeframe:
1 week for legal practitioner referrals
Program name:
Court Integrated Services Program (CISP)
Pilot name:
CCV CISP Pilot
Jurisdiction:
Victoria, Australia
Courts:
Melbourne Magistrates’ Court; County Court of Victoria; Magistrates’ Court of Victoria
Initial establishment:
November 2006
Pilot commencement date:
11 November 2020
County Court service availability:
From January 2021
Target cohort:
Accused persons in the Indictable Crime Stream
Eligibility criteria:
Eligible for bail or relevant deferral of sentencing; not currently sentenced to parole or Community Corrections Order; consent to participate; identified support needs
Exclusions:
Persons accused of sex offences at the County Court; persons unable to comply due to significant support needs
Services provided:
Case management; drug and alcohol treatment; crisis and supported accommodation; disability services; mental health services; acquired brain injury services
Assessment process:
Evidence-based screening assessment and formal risk assessment
Program duration:
Flexible; may exceed 3–4 months depending on risk and need
Review mechanism:
Judicial CISP review hearings
Evaluation:
Three-year evaluation conducted by the University of Melbourne
Referral process:
CISP referral form submitted to relevant jurisdiction; legal practitioners via eLodgment; self-referrals via email
Contact person:
Anna Murru, Manager, CISP Pilot, County Court of Victoria
Year:
2021
Region / City:
Victoria, Australia
Document Type:
Application Form
Organization:
Court Services Victoria
Position Title:
Advanced Case Manager, Court Integrated Services Program (CISP)
Position Number:
CC0202
Division:
Specialist Courts
Employment Status:
Full-time, Fixed-term to April 30 2022
Reports To:
Manager, CISP Pilot
Location:
Remote / County Court, 250 William Street, Melbourne
Key Selection Criteria:
Assessment and case management of clients with complex needs; Stakeholder relationship management
Checks Required:
Criminal record check, Working with Children Check, Professional references, Medical check
Legal Authorization:
Entitled to work in Australia
Year:
2023
Region / City:
Penn Yan, NY
Topic:
Mental Health Services, Housing Assistance
Document Type:
Referral Form
Organization:
Yates County Adult SPOA
Author:
Yates County Mental Health Services
Target Audience:
Health and social service providers, individuals with mental health concerns
Effective Period:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Contextual Description:
A referral form for supportive housing, ACT services, and non-Medicaid care management for individuals with mental health diagnoses in Yates County.
Year:
2023
Region / City:
North Central London
Topic:
Healthcare Referral Form
Document Type:
Referral Form
Organization / Institution:
North Central London
Author:
N/A
Target Audience:
Healthcare professionals
Period of Validity:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Year:
2020
Region / City:
United States
Theme:
Emergency Housing Assistance, COVID-19 Response
Document Type:
Referral Form
Author:
SSVF
Target Audience:
Veterans, SSVF Grantees, Community Stakeholders
Action Period:
During COVID-19 Pandemic
Approval Date:
N/A
Date of Changes:
N/A
Context:
A referral form used for Emergency Housing Assistance under the SSVF program during the COVID-19 crisis, outlining eligibility and procedures for providing temporary housing to at-risk Veterans.
Year:
20XX
Region / City:
Illinois
Topic:
Affordable Housing
Document Type:
Agreement
Organization / Institution:
Illinois Housing Development Authority
Author:
Not specified
Target Audience:
Property Managers, Housing Authorities, Service Providers
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2024
Region / City:
Gwent, Wales
Theme:
Child Safeguarding
Document Type:
Referral Form
Institution / Organization:
Various Local Authorities in Wales
Author:
Not specified
Target Audience:
Professionals involved in child safeguarding
Period of validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2023
Region / City:
Perth, Australia
Topic:
Psychosocial support, Mental health recovery, Social services
Document type:
Referral form
Organization:
Richmind WA
Target Audience:
Individuals experiencing mental health challenges
Period of validity:
6 to 12 months
Date of approval:
Not specified
Date of amendments:
Not specified
Year:
2023
Region / City:
Inner Eastern Melbourne, Outer Eastern Melbourne, Southern Melbourne, Inner Gippsland, Outer Gippsland
Subject:
Early childhood support, National Disability Insurance Scheme
Document type:
Referral form
Organization / Institution:
National Disability Insurance Scheme (NDIS)
Author:
National Disability Insurance Scheme (NDIS)
Target audience:
Families and carers of children with developmental concerns or disabilities under 9 years old
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Subject:
Referral Process for Nursing Home Residents Regarding Return to the Community
Document Type:
Instructional Form
Agency:
Department of Health Services (DHS)
Author:
Division of Quality of Assurance
Target Audience:
Skilled Nursing Facility (SNF) Staff
Period of Validity:
Not Specified
Approval Date:
Not Specified
Modification Date:
Not Specified
Year:
Not specified
Region / City:
Devon, England
Theme:
Adult ADHD Assessment and Treatment
Document Type:
Referral Form
Organization / Institution:
Harrow Health CIC
Author:
Not specified
Target Audience:
Healthcare professionals, GPs
Period of Validity:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2026
Region / City:
United Kingdom
Topic:
Paediatric fatigue assessment and referral
Document Type:
Referral Form
Organization / Institution:
NHS
Author:
Not specified
Target Audience:
Healthcare professionals
Period of Validity:
Indefinite
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2025
Date:
7 April 2025
Region / City:
Swindon and Wiltshire, Gloucestershire
Country:
United Kingdom
Healthcare System:
NHS
Clinical Area:
Diabetes foot care
Topic:
Diabetic foot ulcer referral pathways
Document Type:
Clinical referral guidance and referral form
Issuing Organizations:
Gloucestershire Hospitals NHS Foundation Trust; Wiltshire Community Podiatry; Swindon Community Podiatry
Target Audience:
General practitioners, community podiatrists, healthcare professionals
Referral Pathways:
Same Day Emergency Care (SDEC); Foot Attack Clinic; Community Podiatry; Vascular Surgery
Urgency Categories:
Urgent referrals; Routine referrals
Associated Services:
Diabetes Foot MDT; Community Diabetes Teams
Clinical Conditions Covered:
Diabetic foot ulceration; infection; ischaemia; Charcot foot; neuropathy
Required Clinical Information:
Patient demographics; diabetes history; comorbidities; ulcer characteristics; investigations; treatments
Investigations Referenced:
Blood tests; wound swab; tissue sample; X-ray; ultrasound
Contact Methods:
Email referrals; ERS submissions; telephone
Period of Applicability:
Ongoing as of April 2025
Year:
2026
Region / City:
Oxford, UK
Document Type:
Referral Form
Institution:
Oxford University Hospitals NHS Foundation Trust
Intended Audience:
General Practitioners, Hospital Consultants
Clinical Focus:
Bone and Joint Infections
Required Attachments:
Imaging, Microbiology Results
Referral Method:
Direct email for hospital referrals, e-referral service for GPs
Patient Eligibility:
UK residents
Year:
2024
Region / City:
Minnesota
Subject:
Child Care, Training Delivery
Document Type:
RFP (Request for Proposals)
Organ / Institution:
DCYF (Department of Children, Youth, and Families)
Author:
Not specified
Target Audience:
Organizations or agencies applying to provide child care training services
Period of Action:
FY26/FY27
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Region / City:
Denbighshire
Theme:
Housing Support
Document Type:
Referral Form
Organization / Institution:
Denbighshire County Council
Author:
Denbighshire County Council
Target Audience:
Social Services, Health, Local Authority Homeless Team, Police, Probation, YOT, Housing Associations, Hostels, and other related services
Effective Period:
From April 1st, 2024
Approval Date:
January 2024
Date of Changes:
N/A
Note:
Year
Topic:
ICT Products and Services
Document Type:
Order Form
Note:
Year