Assessment Packages & Information
The primary purpose of these assessment packages is for client referral to Wilp Si’Satxw Community Healing Centre. The assessment package may also be used for referring a client to another type of agency other than a treatment Centre as it is consistent with the information collected for other National Native Alcohol & Drug Abuse Program funded treatment centres.
Please download and fill out the appropriate form with your client, then email it to our intake person at email@example.com. Alternatively, you can print the form and mail or fax it.
To download, click the appropriate link for yourself to open the form, then right-click on the form and select “Save As”.
ADULT REFERRAL & ASSESSMENT PACKAGE
THESE MUST BE FILLED OUT TO ATTEND THIS CLINIC
CONSENT FOR RELEASE OF INFORMATION
All assessment and referral packages are filled out with the client and returned to Wilp Si’Satxw Community Healing Centre. The complete application, including pre-admission medical exam and T.B. test (only if T.B. test is positive then a chest x-ray is required), must be submitted before booking a treatment date. Please be advised clients will be booked as we receive their Complete referral package and medical examinations by mail or by fax.
Applications are accepted by referral from any of the following sources:
Alcohol & Drug Counselors
Band Social Workers
All Referral Workers
Any Treatment or Recovery Centre
Please click here for guidance on writing the referral letter.