Referrals

Referral process for outside agencies.

One form and one centralized location. The referral process for becoming a client at the Center for Mental Health is easier than ever.

All referrals go to one centralized email folder or can be faxed to one location and clients will then be contacted. The email address is [email protected] and fax number is 970-252-3208  (Attn: Utilization Management Coordinator).

External Referral Form (fillable) 11202020

12Authorization for Release of Information (ROI) 12992021

Spanish (ROI) Authorization or Use and Disclosure of Health Information (fillable)10122020