Minnesota CarePartner

Your partner in care.

call: 612.289.5656  |  email: info@mncarepartner.com

 

Make a Referral
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You are here: Home / Make a Referral

Make a Referral

COVID-19 Service Options

Please note that all of our services have transitioned to teletherapy.
We are accepting new referrals for all services. Please indicate in the referral form if there are any barriers to receiving services via teletherapy. Click to read more about our agency’s response to COVID-19 and our teletherapy platform.

Learn More

Please choose a referral type below


  • Mental Health Services Referral
  • Roots Recovery Addiction Treatment
  • Community Partner Referral

This page gives you two convenient options to submit a referral.

  1. WEB BASED FORM – Use our convenient and secure Web-Based Referral Form to submit all your information directly through the web-browser.   OR
  2. PRE-FILLED PDF – If you have already completed our fillable PDF Referral Form – you can upload that by clicking on the “Click Here to Upload a PDF Referral Form” below.  You do not have to complete the web referral if you’ve filled out the PDF.   You will upload the PDF to this form.  Download our PDF Referral Form here.    There is a button at the end of the PDF form to submit the form. It will bring you back to this page to upload it once complete. 
Click Here for our Web-Based Referral Form
Click Here to Upload a PDF Referral Form

Click on the button below to be taken to our web-based referral form. Alternatively, you can download the PDF referral forms below and send those to roots@mncarepartner.com
Roots Recovery Web Referral Form

Fillable PDF Forms

Adult Referral FormDownload
Release-of-Information-Prefilled-2Download

This form should only be used by our official community partners.   

Community Partner Referral

Standard referral form for all MH services.
  • Client Information

  • Minor Guardian & Contact Details

  • Please enter primary guardian(s) first. Include all parties with guardianship or custody status.
    NameRelationshipCustody StatusPhone Number 
  • Referent Information

  • Drop files here or

Contact

call: 612-289-5656
email: info@mncarepartner.com
fax: 651-925-0278

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