• Referral Form

  • Please make a referral by completing the following fields and clicking submit, or print off the form and fax to the client's preferred clinic location. If referring more than one client in the same family, please list all names on one form and only submit once.
  • *Please Note: Records are Needed for referrals to ACT and IRTS. 

    Please send a recent Diagnotic Assessment, Psychiatric Evaluations, Medication Lists, and recent progress notes, along with any other pertinent information by fax to:

    Northway IRTS: 320.529.4909

    St Cloud ACT: 320.253.4179

    Monticello ACT: 763.271.5350

    Elk River ACT: 763.274.1165

     

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