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Refer someone

Refer someone for employment, day or in-home services. It takes about three minutes.

Preview site. This form is for testing only. Do not enter real client information. Nothing sent here is saved.

  1. About you
  2. The person
  3. Services

About you

You are

The person you are referring

If you are referring yourself, enter your own details.

Who should we contact first?

Services

Which services? Choose all that apply.

Availability, transportation needs or goals. Please do not include diagnoses or medical details.

Your information is encrypted and only seen by our intake team. We never put client details in email.

What happens next

  1. We confirm we received your referral.
  2. Our intake team calls you or the person to learn more.
  3. We schedule an intake meeting and coordinate with the case manager.

Prefer fax or email?

Fax: 612-545-5459
Email: referral@peaceofmindcarecenter.com

Questions? Call 612-259-7523.

For case managers: if VRS is closed or waitlisted, include the VRS letter so we can start Employment Development through the waiver.