Fraser Health Overdose Outreach Team Referral Form

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  • Create Date January 30, 2024
  • Last Updated January 30, 2024

Fraser Health Overdose Outreach Team Referral Form

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Created at the request of the Chilliwack Division of Family Practice and Dr. Richard Darby. Referral to the Fraser Health Overdose Outreach Team. Please be aware - there are 2 email links and they are not the same. The first requests a call back to the office (with the name of the physician, the clinic phone number, and the name of the clinic embedded in the email) to discuss a possible referral. The second is to send off a referral form.

This eForm is protected by the GNU General Public License version 2 (GPLv2)

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FH_OOT_Referral_Form_2024.zipDownload