Referral Process
To make a referral to our Residential Level III Programs please email the below clinical documentation to: admin@lsjrp.org
Items Needed
-CCA within the last 30 days
-with Level III recommendation
-PCP within the last 30 days
-Clinical notes within the last 90 days
-Current list of medications
-Psychological Evaluation(s)
-IEP/504 if applicable
-Placement history
Next Steps
Once all documentation is received our clinical team will review and follow up regarding whether the client is being considered.
All clients under consideration are scheduled for a pre-admission interview and these are typically on Mondays and Wednesdays.
Final decisions are made when all interviews are completed.
REQUIRED DOCUMENTATION FOR ADMISSION
Person Centered Plan (PCP)
*Must be within 30 days
IEP/504 Educational Report
Medication Orders/Prescriptions *30 day prescription(s) required
CCA/CCA-Addendum within 30 days *With Level III recommendation
Parent/Guardian Identification
Current School Records
Service Order *Must be within 30 days
Birth Certificate
Immunization Records
Social Security Card
Most Recent Physical Exam
Behavioral Intervention Plan
*Required for Day Treatment Services
Please note:
All residents must meet criteria for Level III Placement and all required documentation must be received prior to admission.