Page 1 of 1

Referral Request

Post a client you cannot take so a colleague who fits can pick it up. Your name and email go out with the request so members reach you directly. No identifying client details, please.

Email

Your name

Your email

Shown with the request so colleagues reach you directly.

Population / who it is for

e.g., young couple becoming parents.

Location

Insurance / fee

The hardest filter - be specific (e.g., "Alameda Alliance Medi-Cal" or "$150, some sliding scale").

Modality

Timing

Context

Why you are referring out and what makes a good fit. No identifying client details

Supervisor of record (if applicable)