Referral

Refer someone to our care.

Case managers, family members, guardians, and self-referrals are all welcome. We'll follow up within one business day.

Prefer to talk?

(952) 208-1624

Monday–Friday, 8:00 AM – 5:00 PM

Referrals are reviewed by our intake team for service fit, authorization, and program capacity.

Please enable JavaScript in your browser to complete this form.
Referring Party Information
Individual Being Referred
Guardian or Legal Representative (if applicable)
Services Requested (check all that apply)
Basic Support Services
Intervention Support Services
In-Home Support Services
Residential Supports and Services
Employment Services
Additional Information
Current Waiver (if any)
Supporting Documents (if available)
Click or drag a file to this area to upload.