Refer a patient

What can COLARC offer?

  • Three Meals Daily
  • Housing Assistance
  • Medical Social Work Assessment
  • Case Management Services
  • Community Resources for SUD Treatment
  • Referral to home Covid-19 Vaccinations and Boosters
  • Family Re-unification (if applicable)
  • Minimizing ED visits
  • Referral and Coordination to Home Health Services
  • Follow Up Visits to Medical Appointments
  • Life Skills Activities
  • Referral to Counseling and Psychiatric Care 

COLARC patient intake/referral form

STEP 01

Download the referral form

Download Referral form

STEP 02

We will require the following to review:

  1. Completed Referral/Intake Form (download above)
  2. DC Summary with Face sheet, H&P, Medication List, and Any Other Supporting Clinical Documents

STEP 03

Fax or email the required documents above:

We will be in touch with you within 30 minutes of the time your referral was received.