Professionals/providers who would like to refer an individual to the CSB should complete and submit two forms by fax to 703-653-6688:
- A & R Instructions.
- An Authorization to Disclose or Request Protected Health Information form.
- CSB Referral Form.
- Request to Release Information Form.
Contact the CSB Entry & Referral office at 703-383-8500 with questions.
Looking for services for a family member with developmental (including intellectual) disabilities? To learn more about the application process and to schedule an appointment please call 703-324-4400 (TTY 711) to contact an Intake Support Coordinator.