Visit the KBH referral website. 

• Click on Professional

• The first time you visit the site you will need to select Register New User

• User Name: Choose a user name- can be your email address
• Email: Enter your email
• Password: Create and confirm a password
• Enter your first and last name
• Are you a DHHS worker?: select No
• Where are you referring from?: select SCHOOL from the dropdown menu
• Primary Care Provider: leave blank
• Click Register
• Click on Add New Referral in the top left of the screen

• Referrer Information:  The first two questions will pre-populate, and indicate whether the client is a minor
• Referral Information:  enter students name, DOB etc. Office site can be left blank or choose the nearest KBH location.

Caregiver Information:  Enter info for the primary guardian and include the nature of the relationship and as much contact information as you have.  Use the buttons to copy if mailing and/or physical address are the same. Skip phone info, if already included. To add an additional caregiver, click add additional caregiver. 

Additional information:  this is where you’ll include the concerns/reason for the referral. From the drop-down box, choose the primary reason for the referral and then any secondary concerns, if applicable.

Services Requested:  Choose School-based & In-Home Counseling in the second box, leave the third box blank, and check no for the last question. 

• Referral Information:  Include your name and contact information.  If the referral is complete, click complete to submit to the Access Department. If more information is needed, you can click Save and come back to the form at a later time.

• After submitting you will be back at the home screen where you can see that the referral has been submitted. If you would like a paper copy, click on Edit, PDF, or ROI and print from the next screen. 

Questions about submission?  Feel free to call the Access Department at 1-888-322-2136