Referral Form – Multiple Referrals

NOTE 1: We want you, our referral partner, to do what is easiest at your end. Submitting this form online allows us at BCRJP to merge the data into our system, however, if it is quicker for you to Download This Form and FAX it to us (715-736-0217), or to send the form from your computer as an email attachment, those options are good, too.

NOTE 2: We also want you to recommend the best program you see fit for the case. In some cases, however, our intake process may lead us to choose a different program (typically, restorative conferencing), and in such an instance, we will always call you first to discuss our recommendations.

NOTE 3: If you are not sure if a referral is appropriate, we always invite you to call us (715-736-0940) so that we can mutually discern the best path to take.