Highland Rivers Community Service Board
Agency Referrals

REFERRAL FORM - Child & Adolescent Program

Thank you for your referral. Highland Rivers is committed to providing excellent care to our communities and we appreciate the opportunity to serve.

Please open the Referral form by clicking the link below. Save the completed referral to your desktop and return it as an email attachment to referrals@highlandrivers.org .

If you prefer, you may also fax your survey directly to your nearest Highland Rivers' clinic.

Highland Rivers Referral

For a listing of clinic fax numbers please click here.

REFERRAL FORM - PRTF and Community Transition Planning

Sometimes children's symptoms and behaviors are so severe they need a specialized hospital to provide 24-hour care, diagnosis, and treatment. In Georgia, six Psychiatric Residential Treatment Facilities (PRTFs) have the primary function of diagnosing and treating patients with severe psychiatric disorders who are eighteen years old or younger.

As a Core Provider, Highland Rivers provides assistance to families and service providers who need PRTF placement. Highland Rivers also provides Community Transition Planning (CTP) to help assure that children make successful transitions home from residential treatment.

Please click on the links below for important forms and information. For questions contact Donna Robbins, C&A Residential Coordinator at 770-547-7110 or donnarobbins@highlandrivers.org.

PRTF Admission Checklist and Cover Sheet
PRTF Process for Medicaid and FFS
PRTF Admission Review for Medicaid and FFS
PRTF Admission for Magellan
Highland Rivers Community Transition Planning Referral Form