MAKING A REFERRAL TO ST. FRANCIS FOUNDATION, INC.

Making a referral to St. Francis Foundation is a simple, 2-step process.

1. CALL FIRST AND PLACE THE CLIENT ON THE WAITING LIST!

•      Have the client's file with you when you call.  the following information will be requested:

  • Your name and the name of your treatment center

  • Any priority listings? i.e. -HIV+    -pregnant female   -receiving SSI or turned down for SSI due to substance abuse.

  • Client's Name

  • Age & Race

  • Drug(s) of Choice

  • Expected Date of Discharge

    • NOTE: Client must have a primary diagnosis of Substance Abuse/Dependence

2. FAX OR MAIL TREATMENT INFORMATION TO ST. FRANCIS FOUNDATION IMMEDIATELY.

   • FAX NUMBER - (337) 233-8122

   • MAILING ADDRESS: P.O. BOX 5148 ~ LAFAYETTE, LA. 70502

     • The following information should be included:

     • Psych-Social

     • History and Physical with Diagnosis and results of TB test

     • Any Psychological Testing

     • Discharge Summary or Progress Report

     • The St. Francis Referral Form - COMPLETED BY THE COUNSELOR - NOT THE CLIENT - must be included with the referral information.

Calling in your referral places your client on the Waiting List Immediately.  Faxing or mailing n the Treatment Information as soon thereafter as possible insures that your client will be considered whenever a bed becomes available.  If the Treatment Information has not been received, your client will not be considered when a bed becomes available and his/her name will eventually be removed from the Waiting List.  We need that information in order to insure that the client meets our Admission Criteria.

QUESTIONS OR PROBLEMS?
CALL OUR TREATMENT OFFICE AT:
(337) 233-8115

Click on the button below to download a copy of the
St. Francis Foundation Referral Form  
in Microsoft Word 97® format
and/or
Adobe Reader® format:

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