PROFESSIONAL REFERRALS

Refer to HelpStar Behavioral Health

A complete referral helps the person reach the right service faster.

HelpStar welcomes referrals from licensed clinicians, medical providers, hospitals, schools, care managers, social service programs, community organizations, and authorized referral sources. Each program has specific clinical, functional, payer, and authorization requirements.

Submit a Secure Referral

Referral Cues by Program

OMHC: Psychiatric symptoms, therapy/medication needs.
PRP-A/M: Functional impairment + active treatment connection + Individual NPI.
IOP: ASAM Level 2.1 substance use severity.
SEP: Disability-related employment barriers.

Secure Behavioral Health Referral Form

Submissions are encrypted and transmitted securely to our intake team.

1. Referral Type & Program Requested

Referral Source Category *

Program Requested *

2. Client Demographics

Client Full Legal Name *

Date of Birth *

Client Phone *

Client Email

County / City

Insurance Payer *

Insurance Member ID

3. Referring Practitioner & NPI

Referring Person Name *

Organization / Agency

Referring Practitioner Individual NPI *

Maryland Medicaid requires an active 10-digit Individual NPI for PRP referrals (Effective July 1, 2026). Group/Facility NPIs are invalid.

Referring Phone *

Referring Email *

4. Clinical Summary & Attachments

Reason for Referral / Functional Impairment Summary *

Attach Supporting Document (Assessment, IEP, Discharge Summary)

Max file size 10MB. Allowed formats: PDF, DOC, DOCX, JPG, PNG.

Mandatory Crisis Disclaimer: I acknowledge that this website form is NOT monitored for emergency or crisis situations. If the client is in immediate danger, I will direct them to call 911 or text/call 988. *