INSTITUTIONAL REFERRAL
Institutional Referral
In Phase 1, we operate a referral inquiry process rather than a formal medical referral form that submits sensitive information directly.
Important
Please do not enter or attach medical records, Social Security numbers, insurance numbers, diagnosis reports, or other sensitive personal information in this form. A KSLC staff member will contact you to arrange a safe referral method.
Please do not enter or attach medical records, Social Security numbers, insurance numbers, diagnosis reports, or other sensitive personal information in this form. A KSLC staff member will contact you to arrange a safe referral method.
Looking for a partner organization?
We partner with hospitals, city/county agencies, foundations, churches, nonprofits, senior centers, and colleges.
See Get Involved →