Overview of the Referral Process for CRL

We encourage Medical Staff, Social Service Professionals, Visiting Nurses and other care providers to refer qualified requests to CRL

Welcome to the CRL Referral Process. We are grateful that you are consulting CRL about a particular case you are managing. CRL seeks to be responsive and helpful to you and those you are serving. We are making these forms available on line and you may also download and print any of these forms. You are welcome and encouraged to share information about CRL with colleagues.
There are several steps CRL needs you to take to make this referral process prompt and effective:


Submit the Preliminary Referral form (You may fill this out online)

CRL will do an initial review to let you know right away if your referral meets the basic requirements of the CRL mandate. CRL emphasizes that at this stage the communication about the referral be confidential between you as a care professional, and CRL. You will first be presented with an explanation that we ask you to agree to before you proceed to fill out the preliminary referral form.


Once you receive a positive response from CRL for your referral, CRL will need you to provide a CRL “All-Purpose Release Form”. This form must be completed and signed before CRL is able to fulfill a request. The original signatures on this form must be mailed or given to CRL directly. To expedite the process, signed forms may be faxed and then mailed to CRL.



Once the request has been fulfilled, there is a form that needs to be signed by the recipient (either household or referring professional) that acknowledges the receipt of the CRL item of service as described.

CRL hopes that this process will help meet the urgent needs of your clients promptly and satisfactorily.



You will need to fill out this form online (or download it and email to CRL). Due to privacy issues, this form may not be submitted until #2 is complete.

Fill it out online (preferred)