Coordinated Health Services Referral And Order {JUV036}

SCLAC JUV 036 - COURT PEDIATRIC PROGRAM (CPP) REFERRAL AND ORDER. This is a Los Angeles County Superior Court juvenile form used to request coordination and review of a child’s medical and mental health services through the Court Pediatric Program. This form identifies the child, case details, and involved parties, and outlines specific medical or mental health concerns that require evaluation. It authorizes court-affiliated pediatric specialists to review records and assist with care coordination. The form includes options for routine or urgent referrals and provides instructions for submitting the request to designated court physicians. For Mandatory Use. www.FormsWorkflow.com