Professional Referrals

Refer a Client to Rosie's Recovery Center

Complete the form below and our intake team will follow up within one business day. All referrals are handled with the utmost confidentiality and care.

Referring Provider Information

Provider Name *

Organization / Practice

Phone *

Email *

Relationship to Client

Client Information

Client First Name *

Client Last Name *

Date of Birth

Client Phone

Client Address

Insurance / Payer

Member ID (if known)

Services Requested

Program of Interest *

Urgency Level

Reason for Referral / Clinical Summary *

Additional Notes

All information is kept strictly confidential.

Prefer to Call?

Our intake team is available Monday–Friday, 9am–5pm.

877-500-0595 [email protected]

What Happens Next

Referral reviewed within 1 business day

Intake coordinator contacts the client directly

Insurance & eligibility verified

Initial assessment scheduled

Care plan developed with client

Accreditation

Joint Commission Accredited

State of Maryland Licensed

Psychology Today Verified

COMAR 10.63 Regulated