REFERRAL · CFSS

Make a CFSS referral

For individuals, families, and case managers. It takes about 2 minutes, and our team will call you to talk about next steps.

Referral Form

Fields marked * are required.

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I am making this referral for…

1About you

2About the care needed

On Medical Assistance?
Getting PCA now?
Had a MnCHOICES assessment?

3Anything else

Briefly tell us what kind of help is needed. Please don't include diagnoses or medical details.
Consent

What happens next

1We review your referral.
2We call you to explain CFSS and your options.
3We help with next steps, like the MnCHOICES assessment.

Rather talk to someone?

507-900-1995

Mon–Fri, 9am–5pm · Free interpreter on request

🔒 Your privacy matters. Please don’t email medical or insurance documents. Case managers can upload support plans securely in the form.