Provider Referrals

Providers who have the family's permission are welcome to make referrals for targeted Case Management. It is often helpful to have the Provider Referral information to assist in the process when the family begins the process of referral. Providers should download, complete and return the Provider Referral Form. You may fax or mail the form. FAX: 207-941-2989

Download the Provider Referral Form
Note: You will need Adobe Acrobat Reader or another PDF reader to view and print the form.  If you experience any issues downloading the form, right click on the above link and select "Save Target As" to download it manually.

Verification of the youth's DSM-IV-TM (or ICD-9 Diagnosis for Complex Medical Needs) and Code is necessary to complete the Opening Process. Your Case Manager can help the family obtain copies of the evaluation if needed.


Since Wings is a strictly voluntary program, it is essential that we hear from the parent/guardian before any referral is acted upon. If we receive a Provider Referral, we will try to contact them by telephone several times and then send a letter. If we do not hear back from the parent/guardian, we will send them a letter explaining that we will not be acting on the referral at this time, but if they change their mind, they may contact us at any time.

Community providers will often be part of the Child and Family Team that is pulled together and facilitated by the Wings Case Manager. The parent/guardian chooses the team members and the family is the primary decision maker in the process. The Wings Case Manager will help the process by having the team participate in a strengths and needs planning process.

This process is designed to assist the team in focusing on strengths, identify goals, and develop an Individual Support Plan using the resources discovered by the team. The Child and Family Team format we use helps to "Nothing about them without them " - a phrase that really gets at our philosophy and has proven time and time again to be an effective method of keeping youth and families safe and together.