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Meridian

Clinician tool

Referral tracking sheet

A register for outgoing and incoming referrals: source, date, reason, status, and outcome — flagging pending referrals whose follow-up date has passed.

Stays on this device. Everything you enter here is saved only in this browser (IndexedDB) and is never sent to Meridian or any server — it works offline. Because entries can include client information, use a private, encrypted device, and clear or export to your EHR when you're done. This is a scratchpad, not the medical record of truth.

Referrals

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Pending

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Completed

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Referral register

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Meridian · New Hampshire community mental health. These templates and trackers are general professional aids, not legal advice or a substitute for clinical judgment, agency policy, or applicable statute and payer rules. Verify codes and requirements against current sources.

If a client is in immediate danger, call or text 988 or dial 911.