Referral

Join our Community

 

For people who would like to join our community, we can help.

Please contact us or email us at Referrals@ccinconline.com

 

Patient Referral

 

For patient referrals to Crossroads’ Psychiatric Rehabilitation Program (Adult or Youth), Healthy Transitions (Young Adult 16-25), Supported Employment (Vocational), or Respite Care Services, please use the Crossroads Community Referral Form.

 

To submit a secure, encrypted referral online, click here: Crossroads Community Referral Form
(Note that you may save your form entries and complete at a later time.  Use Save button at bottom of form.)

 

For a printer friendly version, click here to download: Crossroads Community Referral Form PDF

 

 

 

For referral to Crossroads’ Residential Rehabilitation Program, please contact Mid Shore Behavioral Health at 410-770-4801 for an Application for Residential Rehabilitation Services.