Make a Referral

If you are a medical or mental health professional who would like to refer a patient to YCSC, please select one of the following options.

• Submit an on-line referral via Qualtrics.

• Fax referral information including patient name, DOB, and reason for referral to: 203-737-5455

• Submit a referral via Epic to: YM CSC OUTPATIENT YOUTH or YM CSC ASSESSMENT