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Client Referral


If you or a loved one need mental health services, please complete this brief form and a Care Team member will contact you.

Request for Services

If you are a therapist and would like to refer a client to WIN Family Health please select and complete the applicable electronic referral form below.

Psychiatric Rehabilitation Adult Referral Form

Psychiatric Rehabilitation Youth Referral Form

DOWNLOAD Release of Information

Once the referral is processed with all required documents and all paperwork is approved, we will assign a counselor to begin working with the client.

What Health Insurance do you accept?
We currently accept Maryland Medicaid.