Provider Referral Form

Thank you so much for your interest in referring a client to CHC.

Your trust and confidence in our services means the world to us. As a non-profit organization, our mission is to transform young lives by providing culturally-responsive, gold-standard services for learning differences and mental health to families from diverse backgrounds regardless of language, location or ability to pay. Collaborating with other providers in the community is critical to removing barriers to accessing care and we are grateful for your partnership. In order for the process to be seamless and positive for all, we will reach out to your client directly (or to you if that is your stated preference) the same or next business day. Please see here for a complete list of our comprehensive and integrated clinical services.

After you complete the form below, there will be an option to print it or save it to your own device.