Innovative Care Services currently accepts clients through County and MCO referrals along with some private pay. Please select who will be funding the services from the dropdown below.
Please provide any necessary/relevant medical information.
Please provide details for the guardian including name, relationship, number, and email.
Select preferred county for services.
Please provide any additional information regarding your request to help us better address your need.
Please attach any additional information such as (assessment tools, recovery plans, crisis plans, authorization, etc.)
*Member Centered Plan is required to process a referral for residential placement, please attach here to avoid delays*