• PRIDE Therapeutic Mentor (TM) Referral Form

  • Our inclusive PRIDE Team consists of highly qualified mental health professionals and paraprofessionals who are a part of the LGBTQIA+ community. Our PRIDE Team is thoughtful in our choice of respectful language, behaviors, and continued education to best reflect the current needs and expectations of the LGBTQIA+ community."

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  • Clinical Hub Referral Source: (*Required at time of refferal in order to obtain authorization and provide services to youth)

    TM is a Hub-Dependent service, which means the hub is responsible for including TM services on care/treatment plan (as a goal), updating document quarterly and maintaining a minimum of weekly phone contact with assigned TM.

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