CRW Referral Information

Overview

For a client to enroll in either PRIDE Site residential or Project Contact outpatient, they must have New York state based Medicaid. To refer a client, please send their name, Medicaid ID number, email address, phone number, and address to crwintake@edalliance.org. A clinician will then contact the client to schedule a tele-health intake appointment.

Additional items needed for referral to PRIDE Site residential:

• Contact info of referent (phone and email on cover sheet)
• Client target d/c date
• Insurance info- Face Sheet
• Copy of Pic ID (benefit card is okay if that is only ID)
• PPD (or chest X-ray if h/o +PPD)
• Labs
• Psych Eval (only if client has had recent acute symptoms, high risk behavior, hospitalization(s) , or SI/HI)