Information
for Referrals
For Families
We look forward to working with you and your family and hope your time with us is beneficial and supportive.
For an Outpatient Therapy referral, please complete the easy form below to self-refer and we may call you back if we have additional questions.
For our other services, we will need a referral from your current treating therapist and the necessary documentation listed in the "For Providers" section. You or your provider will need to fax those document to our Access Department.
Contact the Access Department with any questions or if you would like more information.
Check out our Family Tip Sheet for essential information.
What to have prepared for the following program referrals:
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Fill out the form to the left in the “For Families” section or fax the following information:
Brief information about the child’s needs
Contact information for guardian
Current living situation
Health insurance information
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A referral from the client’s current provider
The current treatment plan which should include specific goals and objectives for equine treatment
Current mental health assessment and diagnosis
Safety plan
Contact information for the guardian
Health insurance information
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A referral from the client’s current provider
The current treatment plan which should include specific goals and objectives for skills training
Current mental health assessment and diagnosis
Safety plan
Contact information for the guardian
Current living situation
Health insurance information
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A referral from the client’s current provider
Psychiatric and/or clinical assessment
The last three notes from the psychiatrist or PMHNP
current diagnosis, medications, and information about any pertinent health issues
Recent treatment history – either captured within clinical notes or through a written clinical referral letter that clearly describes the current presenting concerns and why facility-based care is being requested
Larger Care Team/Agency involvement such as EASA, DHS, etc.
Psychological assessment (if available)
Contact information for guardian
Current living situation
Health insurance information
Please fax all necessary documentation listed above
to our Access Department: (503) 205-0190
Contact the Access Department
(503) 813-7760 or 1 (888) 333-6177
This email is for general inquiries only.
Do not send clinical information or secure email to this email address.
Please fax clinical documents to 503-205-0190.