The Universal Referral Form (URF) serves as one
application for services to the Westchester County Department of Community Mental Health Children's Mental Health System of Care. Services included intensive case management, again-out services and residential opportunities in the mental health system.
The URF can be downloaded in three parts in PDF format:
- Part 1:
Introduction, Eligibility Information
and Required Information
- Part 2:
Information and Consents to be submitted
You can also download one "self-extracting zip file" which will extract the two files where you wish on your computer (if using a PC). Just download the file and double-click on it to
extract the URF.
NOTE: Don't forget to pick a path to extract the form! Also, don't forget WHERE you chose to extract the forms to!
If you don't have the Acrobat
Reader, you may download it for free by clicking on the link on the left.
Please read the Universal Referral Process
cover page to assist you in completing the form. For additional information regarding the Universal Referral Form please call Michael Orth, Program Administrator (914) 995-5225 or e-mail:
