A referral form can be requested by phone, fax, mail or website. All referrals are processed by Karen Baker/Operations Manager.

Here is our referral form.

Completed applications are reviewed by the director and staff at our weekly staff meetings for acceptance or denial.

We can schedule a consultation with individuals and/or their representatives prior to making a referral to the Chapter. There is no charge for the initial intake process.

*All information is confidential.

Serving adults, children, elderly and those with disabilities since 2000.