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MHAN Referral Form
Mental Health and Addictions Nursing Program Referral Form.
To request the services of the Mental Health & Additions Nurse, the patient must be:
1. A student registered in school and who is no older than 21 years of age (may include home instruction)
2. In need of services or related treatment to an identified and/or suspected mental health and/or addictions issue
3. Aware of and consenting to the referral
Additionally, there must be a clearly defined role for the Mental Health & Addictions Nurse
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