BounceBack Mental Health Referral

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  • File Size 253.83 KB
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  • Create Date November 23, 2022
  • Last Updated December 5, 2022

BounceBack Mental Health Referral

There are two versions:

Adrian Starzynski's version (tested to be compatible with all OSCAR systems):

Referral form to BC's provincially-funded Bounce Back Mental Health Program

Includes fax options and link to the PHQ-9 eForm (you must import the PHQ-9 eForm as well for the link to work) which you use to calculate the patient's PHQ-9 score and insert it into the BounceBack referral form.

Created by Adrian Starzynski.

John Robertson's version:

Created by John Robertson at the request of the Chilliwack Division of Family Practice. Referral to the Bounceback program run by the BC branch of the Canadian Mental Health Association. This new version contains the fax code for those who have built in faxing. It also includes a drop down of the PHQ-9 calculator, a printable version of the PHQ-9 questionnaire (for the patient to fill), a web link, an email link, and age alerts. There is also an alert for a PHQ-9 score over 21 as this is not appropriate for the program.


Download the version of the eForm you want below

Attached Files

FileAction — JohnRDownload — AdrianS — Updated on 2022-11-23Download