Refer a Patient: Early Intervention Services
1. Fill out the referral form
Download and complete our mental health and child development referral form. The child's parent or guardian must fill out the release of information / consent for referral portion of the form for us to process the referral.
2. Send it to us
Fax the completed referral form to (510) 985-2202
(877) 822-4453 (877-UC-CHILD)
Fax Oakland: (510) 985-2202
Fax San Francisco: (415) 353-4485