Referrals

Make a Referral

We welcome referrals from county case managers, social workers, guardians, and family members across Minnesota. Complete the form below and our intake team will respond within 1 business day.

For urgent or crisis needs, call us directly: (763) 372-4420

Referral Source

Information about the person or organization making this referral.

Your Full Name *

Organization / Agency

Phone *

Email *

Individual Being Referred

Basic information about the person who will be receiving services.

Client First Name *

Client County *

Primary Diagnosis *

Services Requested

Select all services you are requesting for this individual.

Urgency & Notes

Help us prioritize this referral correctly.

Urgency Level *

Routine (within 2–4 weeks)Urgent (within 1 week)Crisis (immediate — call us now)

Additional Notes

We respond to all referrals within 1 business day. For urgent needs or crisis situations, please call us directly at (763) 372-4420.

* Required fields