For our referral sources

Make the connection.
Help someone move forward.

Connect a client with Regional Management Care for therapy, psychiatry, targeted case management or psychosocial rehabilitation.

RMC serves clients ages 5 and older. Service eligibility, coverage and clinician availability are reviewed by our intake team.

Complete RMC’s existing Fillout form below to submit your referral.

Submit your referral

RMC client referral form.

If the form does not load, open the existing referral page or call 954-474-7373.

A clear path to care

What happens after you refer?

01

Submit the referral

Include your organization, name, email and phone number, along with the client details and requested service. Provide the required referral documentation through the existing form.

02

Intake reviews & contacts

Our team reviews the referral and contacts the client to discuss next steps. Please provide accurate contact information so we can reach them.

03

Stay connected

For a referral status update or to provide additional information, call our intake team. Have your referral date and organization name ready.

    Before you submit.

    Referral source details

    Include the referring organization and the best contact person, email address and telephone number for follow-up.

    Client information & documents

    Provide accurate client contact information, requested services and insurance details. Include a psychiatric evaluation or biopsychosocial assessment when required for the referral.

    Ensure you have the appropriate authorization to share client information. Our team can help clarify which documents are needed for the requested service.

    Community connections

    Our behavioral health partners.

    Connecting mental health care, housing resources and community support across Broward County.

    Refer someone to RMC for therapy, psychiatry or community support services.

    Refer a Client