Referral Information

To refer a client to PRIDE Site residential or Project Contact Outpatient, send the client’s name, Medicaid ID number, email address, phone number, and address to 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)
  • History and Physical -Part B
  • Psychosocial –Part C
  • 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)

Current exclusions/caveats:

  • Must have New York City based Medicaid
  • Cannot accept methadone currently in residential (due to off-site dosing and elevated COVID exposure risks but okay for outpatient)
  • We do not have the bandwidth to work with clients with psychotic disorders (i.e.Schizophrenia/ Schizoaffective d/o) in the residential program but not necessarily exclusionary for the outpatient program, depends on the intake process
  • Clients with recent violent criminal charges, arson or sex offenses cannot be accepted (no menacing, harassment, assault, etc.)