Referrals Hub

Connecting individuals and organizations to the right level of care and support. We streamline the path from referral to enrollment.

Referral Forms

Self-Referral Form

For individuals or family members seeking Medi-Cal services for themselves or a loved one. Start your journey here.

Organization Referral Form

For Hospitals, Clinics, Shelters, and CBOs. Use this form to refer a client for ECM or Housing Navigation services.

Parental Consent Form

Required for any member under the age of 18. This form must be signed by a parent or legal guardian to authorize services.

HIPAA Authorization

Standard Release of Information (ROI) form. Allows us to share medical records and coordinate care with other providers.

Who Can Submit a Referral?

Risen Health Partners welcomes referrals from individuals, families, hospitals, clinics, shelters, community-based organizations, and Medi-Cal Managed Care Plans. Referral submission does not guarantee eligibility, coverage, or authorization. When services are requested through a Managed Care Plan, the plan’s coverage and authorization requirements apply.

  • Hospitals and discharge planners
  • Managed Care Plans and provider network teams
  • Homeless services providers
  • Individuals and families

We review submitted information and coordinate appropriate next steps. Response times depend on referral completeness, eligibility verification, and applicable authorization processes.

Medical content reviewed and validated by Ekaterina Timofeeva, PhD.