PATIENT REFERRALS
24/7 HOUR CRISIS HELP CALL (800) 552-3106 OR TEXT "IN" TO 741-741

At Four County we are committed to ensuring ease of referrals from local community partners


To make a physician referral, please download the PCP referral form and fax to (574) 732-0428

If you are a school making a student referral, please download one of the school-linkage forms below and email to school@fourcounty.org
- Four County School Based Linkage Form
- Four County Spanish School Based Linkage Form

Are you a probation officer or community corrections staff needing to make a referral? Please send your inquiry or referral to criminaljustice@fourcounty.org

Referrals from the Department of Child Services are submitted through the KidsTrak state database. Please send any questions to DCSreferral@fourcounty.com

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