Child Abuse Research Education and Service Institute
How to Make a Referral
- Complete and sign the forms listed below:
- Complete the CHEC Referral Form.
- Sign the Consent Form. Please note that CP&P or a biological parent may sign. If the child is 14 or over, he/she will also need to sign.
- Sign the Notification of Patient Privacy Form in the medical and mental health sections. Please note that CP&P or a biological parent may sign. If the child is 14 or over, he/she will also need to sign. This form states that you have received our policies on patient privacy. These policies can be viewed below:
- Sign the CHEC Eligibility Form. Please note that the Local Office Manager must sign this form if the child has already had a CHEC, CME or Well-Child Visit during the current placement episode.
- Obtain immunization records. These records are often available from:
- Medical provider
- Daycare
- School
- Parent/caregiver
- Fax completed forms and immunization records.
- Fax Referral, Consent, Notification of Patient Privacy, and CHEC Eligibility forms (above) and the immunization records to 856-566-6838.
- Upon receipt of the fax, we will call you to schedule an appointment.
Comprehensive Health Evaluation for Children
- A one-time mental health & substance abuse screening, developmental evaluation, & comprehensive physical examination
- Includes recommendations and referrals
- By DCP&P mandate, all children initially entering foster & kinship homes
- Appointment within 30 days of placement
- Provide information about the child to DCP&P staff, Resource Parents, primary care provider, HMO care coordinator, & others
- Identify medical, developmental, & mental health difficulties with recommendations for improvement
- Identify the child's strengths
- Completed referral form and signed consent, notification of patient privacy, and patient eligibility forms
- Child's immunization record
- Medical records, school records, and any evaluation reports are also extremely helpful
- Both resource parents & DCP&P caseworkers are encouraged to participate, but only one needs to attend the visit
- An adult must stay with the child for the CHEC visit
- Transportation aids may remain with the child during the visit, but someone who knows the child (such as a caseworker, foster parent, or biological parent) also needs to be present for a short portion of the appointment to provide information
- Birth - 12 months: 2.5 hours
- 1 - 5 years: 3 hours
- 6 - 11 years: 3.5 hours
- 12 - 17 years: 4 hours
- No SAR is needed
- Fax completed forms to 856-566-6838 (Fax)
- CHEC evaluations appointments are Monday through Friday