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Looking Glass Residence Referral

To refer a patient to the Looking Glass Residence, please follow the referral process and use the referral form below.

Referrals form

Referrals process

1Check the criteria for referral

Please check the eligibility criteria.

2Fill out the form

Referral form must be filled out completely. Incomplete referral will not be processed. Include all the required information (see Before or after care restrictions section of the referral criteria document). 

3Submit the form

Submit the form and the required information as instructed on the form.

Intake Coordinator will connect with health professional and youth or young adult to begin intake process and arrange for pre-admission assessment,

SOURCE: Looking Glass Residence Referral ( )
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