BHS Referral Form

Referral for Behavioral Health Services

Instructions on How to Complete and Submit the Online Referral Form

  1. Fill in the Required Information: Complete all necessary fields in the referral form. Ensure that you provide accurate and up-to-date information to avoid any delays or errors in processing the referral. Make sure the email address for the referring party is correct (page 1) and the email address on the signature page is correct. 
  2. Save Your Progress: If you need to save your progress and return to complete the form later, ensure you go to Options on the top left corner under CAHELP and click Save progress. You will be prompted to enter your name and email address. This feature allows you to save your work and resume from where you left off when you revisit the form that will be emailed to you.
  3. Review and Sign: Before submitting the form, carefully review all the information provided to ensure its accuracy. Sign the form electronically using the provided signature field.
  4. Submit the Form: Once you have filled out all the required fields, and provided your electronic signature, and verified the email address is correct, click on the “Click to Sign” button at the bottom of the form.
  5. Confirming Email Address: To ensure accuracy and validity, a confirmation email will be sent to the referring party’s email address before the referral form can be completed. The confirmation request will come from Adobe Acrobat Sign. Please be sure to follow the instructions in the email to confirm your signature and verify the email address provided. Your referral will be successfully submitted once the confirmation process is complete.
  6. Confirmation Receipt: After successfully confirming your signature, you will receive an email from CAHELP via Adobe Acobat Sign. This email will contain a completed and printable version of the referral form for your records. If you choose to open the agreement it will take you to a web page of the completed referral. (NOTE: You will have to download the PDF if you choose this function.)
  7. Printing the Form: Please note that you will not be able to print a copy of the form while completing the document online. However, you can print the completed form from the PDF attached to the confirmation email sent to you.

If you are experiencing any issues, please contact our office at (760) 955-3601 or by e-mail at [email protected].