Make A Referral

Lower Shore Clinic Intake Forms

Client Registration Form

Fom Enskripsyon Kiyan

Formulario de Registro de Cliente

Click to open the PDF referral document you need.

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• Psychiatric Rehabilitation and Vocational Referral

• Assertive Community Treatment Referral

• Crisis Services Referral

• Residential Rehabilitation Referral

Next Steps

Please submit all paperwork (with signatures) to Lower Shore Clinic front desk via fax or email.

• fax 410- 341-3397

• email referral@lowershoreclinic.org

Feel free to send us a message if you need help.

Accepted Insurance Policies

Please review our list of accepted insurance policies.

We also offer a Sliding Fee Scale for those who cannot afford care.  No one is denied access to care due to inability to pay.  The sliding fee scale is based on family size and income level.  Proof of income is required.  One month's income statements or tax filing information is acceptable.