Should you be in need of a referral you can click below on the appropriate form. Please note referrals must be signed by a licensed clinician; if you are not currently working with a licensed clinician, contact our office and we can assist you through the process. Completed referrals are to be directed to the Program Director, Sam Richberg, if unable to bring it into the office it can be sent either via:
fax: 443-221-7879 (Annapolis Office in AA County)
fax: 240-582-7378 (Landover Office in PG County)
REFERRAL FOR SERVICES
We provide comprehensive treatment to children, adolescences, adults, and families throughout the state of Maryland. To be eligible to receive services an individual must have all of the following:
1) Maryland Medicaid;
2) Currently working with a licensed clinician;
3) Must be at least 5 years of age or older
4) If over the age of 18 a psychiatric diagnosis that meets the “priority population” criteria
WE SUPPORT. WE ADVOCATE. WE EMPOWER. YOU ACHIEVE.
For ABHC Adult Referral Form please click here
Referral forms cannot be submitted through the website, it must be emailed, faxed, or brought into the office.
For ABHC C&A Referral Form please click here