For healthcare professionals

Adult Day Health Care (CBAS) keeps your patients engaged, monitored and out of the emergency room. Referring takes a few minutes.

Who we serve

Adults 18 and older with Medi-Cal, including dual-eligible members
Chronic conditions needing monitoring: diabetes, heart failure, COPD, hypertension
Dementia and other cognitive impairment
Post-hospital and post-rehab recovery
Serious mental illness with need for structure and socialization
Isolated older adults at risk of decline

We contact the caregiver and confirm receipt with you within one business day. The health plan's assessment typically follows within a few weeks.

Use the referral form below. It reaches our intake team immediately.

Fax the referral sheet to (818) 570-7733. Print it from the link below.

Call (818) 570-7771 and ask for intake.

This form is for professional referrals. Please do not attach clinical documents here; fax them or send them through your secure channel.

Participant namePlease fill in this field.

Date of birthPlease fill in this field.

Participant or home phonePlease enter a phone number we can call.

Preferred languagePlease fill in this field.

Health planPlease fill in this field.

Member IDPlease fill in this field.

Primary diagnoses / reason for referralBrief summary only. Send clinical documents by fax.Please fill in this field.

Caregiver name and relationshipPlease fill in this field.

Caregiver phonePlease enter a phone number we can call.

Your name and rolePlease fill in this field.

OrganizationPlease fill in this field.

Your phonePlease enter a phone number we can call.

Your fax or emailPlease fill in this field.