Submit a Referral
Instructions on How to Complete and Submit the Online Referral Form
Note: "Please avoid using autofill when entering the email address. Manually typing it ensures that client information remains accurate and does not get updated to any pre-filled data."
Fill in the Required Information
Complete all required fields in the referral form. Use accurate and current information. This helps prevent delays or errors. Make sure the referring party’s email address is correct on page 1. Also check the email address on the signature page.
Save Your Progress
To save your work, go to Options in the top-left corner under CAHELP. Then click Save progress. You will be asked to enter your name and email address. A link will be emailed to you. Use that link to return to the form later.
Review and Sign
Before submitting the form, review all information carefully. Make sure everything is accurate. Then sign the form electronically in the signature field.
Submit the Form
After completing all required fields, review your information again. Make sure your electronic signature is included. Check that the email address is correct. Then click the Click to Sign button at the bottom of the form.
Confirm Your Email Address
Adobe Acrobat Sign will send an email to the referring party’s email address. Open the email and click Confirm my email address. This step must be completed before the referral form can be submitted.
Confirmation Receipt
After confirming your signature, you will receive an email from CAHELP through Adobe Acrobat Sign. The email will include a completed PDF copy of the referral form. You may print this copy for your records. You do not need to forward the confirmation to the DMCC.
Printing the Form
You cannot print the form while completing it online. After submission, you can print the completed PDF attached to your confirmation email.
