referral

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What we do begins with your call.

Parents and caregivers, to make a referral or to inquire about our services, please contact our Intake and Referral telephone line by dialing (510) 269-9043.

Social workers and other providers, please submit this intake form by fax following instructions on the form (for privacy reasons do not email the form).

New and current patients can access policies and consent forms here.

Our Intake and Referral line is confidential and is available 24 hours a day. Please be prepared to leave a message with your name and telephone number and an Intake Clinician will return your call as soon as we are able.

If you’d like to make a referral for services, please follow the steps below:

The first step in our intake process is to establish MediCal eligibility. To establish MediCal eligibility, please leave a message including:

  • The child’s first and last name
  • Child’s Date of Birth
  • Child’s Social Security Number or MediCal card number
  • Your name and telephone number

Once we establish the MediCal benefit, you will receive a call from an intake clinician in which you will be asked to complete a 20 to 30 minute Intake Interview. To read more about our intake process, please see our Intake Schedule and Process page.

Accommodations are made for persons with disabilities. Please make the Intake Clinician aware of any special needs you may have at the time of your call.

If we cannot meet your needs, we make every effort possible to provide you with names and numbers of those who might be able to help.