Referral Forms

Due to the COVID-19 restrictions we are currently not having our Residential Treatment Readiness Screening Group located at our downtown facility on Fridays at 2 pm. 

Adult Residential Referral

The Adult Residential Referral Packet should be used if your client is:

  • Hospitalized or residing in a facility
  • Incarcerated
  • Not living in Clackamas, Multnomah or Washington counties

For clients who meet the above criteria, please complete the Adult Residential Referral Packet following the instructions provided. If available, please fax a drug & alcohol ASAM assessment and medical/mental health records to (503) 535-1163 along with the referral packet.  This will make admissions or placement on the residential waitlist much quicker.

If your client DOES reside in the Clackamas, Multnomah or Washington County areas, please direct them to call our facility at (503) 535-1151 to speak to an Access Specialist. They will then receive an assessment over the phone to determine if they are appropriate for our residential treatment program.

Adult Residential Referral Packet

Read more about our Adult Residential Treatment Program

 

Medically Monitored Adult Residential Referral

Currently, our Medically Monitored Adult Residential program is only serving HealthShare members.

The Medically Monitored Adult Residential Referral packet should only be used if your client is a HealthShare member and is:

  • Hospitalized or residing in a facility
  • Incarcerated
  • Not living in Clackamas, Multnomah or Washington counties

To refer a client for the Medically Monitored Adult Residential program, please complete the Medically Monitored Adult Residential Referral packet following the instructions provided. If available, please fax a drug & alcohol ASAM assessment and medical/mental health records to (503) 535-1163 along with their Referral Packet.  This will make admissions or placement on the residential waitlist much quicker.

Medically Monitored Adult Residential Referral Packet

Read more about our MMART Program

 

Youth Residential Referral

The Fora Health Youth & Family Center provides substance use and co-occurring mental health disorder treatment for male-identifying clients ages 13 to 18.  We will work with you to find the right substance use disorder treatment plan that fits the needs of your client.  To begin the admissions process, please complete the Youth Program Referral Form following the instructions provided.

Youth Residential Referral Form

Read more about our Youth Residential Program