Community Referral Network



Community Referral Network is a web-centric referral system designed to facilitate synergistic relationships with community clinics, hospitals, and social service agencies in order to provide holistic care for their clients. Cognizant of the barriers organizations face when assisting underserved populations obtain care outside their scopeof practice, and given their wide range of needs, the Referral Network is an easy-to-use tool that allows organizations to quickly and accurately refer clients for a variety of services in a matter of seconds. Within the Referral Network there are five functionalities: eConsult, Specialty Care, Hospital Follow-Up, Surgery Waitlist and Social Services.

  

REFERRAL TYPES:
·        Hospital Follow-Up
·         Surgery Waitlist
·         Medical Care
·         Specialty Care
·         Behavioral Health
·         Dental Care
·         Social Services
·         eConsult

For more information on this program or to arrange a complimentary demonstration please contact:
Roseann Peters, Community Referral Network Project Manager
P: (714) 583-6433  E: rpeters@lestonnacfreeclinic.org W: http://www.communityreferralnetwork.org/

Application for CRN Program Setup
Street, City, State, Zip Code
Organization Staff
Name/Title, Phone, Email (The Executive Director or Program Manager responsible for the success of the program)
Name/Title, Phone, Email (The individual that is given the Admin security role. This person is trained, may add or remove other users and make changes to your organization's profile and settings.)
Name/Title, Phone, Email (The individual that typically creates and /or receives referrals)
Your Referrals
Your Services
If you will be PROVIDING a service(s), you will be sent referral notifications and your organization address and phone number will appear on the referral form that the referring agency will print out for their client.
List Your Services
Primary Category/Sub Category Examples: (Social Services - Housing or Transitional Shelter) (Specialty Care - Medical or Acupuncture) Guidance: any special instruction or limitations regarding your service
Your Service Area
Only fill this out if you will be PROVIDING a service.