Make a Referral | Maitri Path to Wellness
Professional Referrals

Refer a Client to Maitri

Connect individuals with compassionate, evidence-based mental health and substance use care. Our intake team will follow up to schedule an assessment and determine the right level of care.


Submit a Referral

For urgent situations, submit this form AND call us directly: (815) 780-0690

Simple. Coordinated. Responsive.

01

You submit the form

Takes 3–5 minutes. Provide what you know — partial information is okay.

02

Our team is notified

Intake staff receive an immediate notification and review the referral.

03

We reach out

We contact the individual to schedule a mental health or substance use assessment.

04

Level of care determined

Assessment results guide the right treatment pathway — at Maitri or coordinated elsewhere.

This form is for professionals and community partners

Law Enforcement
Probation & Parole
Drug Court
Medical Providers
Hospital / ER
Mental Health Providers
Schools & Educators
Social Services
Family & Friends

Services Available at Maitri

We provide outpatient and intensive outpatient treatment for mental health and substance use disorders, peer recovery support, and sober living housing. For needs beyond our scope, we coordinate referrals to appropriate providers.

Mental Health Assessment

Comprehensive evaluation to determine diagnosis and appropriate level of care.

Substance Use Assessment

ASAM-based assessment to determine treatment needs and level of care recommendations.

Outpatient & IOP

Individual and group therapy for mental health and substance use disorders.

Peer Recovery Support

Certified peer recovery specialists providing community-based recovery coaching.

Sober Living — WARM

Safe, structured housing for men and women in recovery. 20-bed capacity.

Inpatient / Detox

We will assess the individual and coordinate referral to the appropriate facility.

MAT / MAR

Medication-assisted treatment referrals coordinated following our assessment.

* Services marked above are not provided directly by Maitri. We will conduct an intake assessment and facilitate the appropriate referral on the client's behalf.

Referral Form

Complete the form below. Provide as much information as you have — partial information is acceptable. Our intake team will follow up with you and the referred individual directly.

⚠ If the individual is in immediate danger, experiencing a psychiatric emergency, or actively overdosing — call 911. For mental health crisis support, call or text 988 (Suicide & Crisis Lifeline). This form is not monitored in real time and is not a substitute for emergency services.

Open Referral Form →

Questions about a referral?

Our intake team is available to answer questions and provide guidance on the referral process.

(815) 780-0690