Statewide NJ DDD Provider • CCP & SP • Medicaid Billing Ready

Coordinator Referral & Documentation

Support Coordinators may submit participant referrals securely using our intake form. If referral information is not immediately available, you may download the referral packet and submit it once documentation is ready.

Secure Referral Intake

Referral Submission Options

Support Coordinators can choose the method that works best for the participant referral. The secure online referral form is the preferred method and allows documentation upload at the time of submission.

  • Submit Referral: Complete the secure intake form and upload available documents.
  • Download Referral Packet: Download the packet for completion and return when documentation is ready.

Step 1

Open the secure referral intake form and enter participant information.

Step 2

Upload ISP/PCP packet, profile photo, and any supporting documentation available.

Step 3

Submit the referral once. Our team reviews submissions and responds within 1–2 business days.

Documents to Include

  • ISP / PCP packet
  • Client profile photo
  • Behavior plan
  • Clinical assessments
  • Approvals / authorizations
  • Additional supporting documents if available

Coordinator Support

Email: info@communityliaisonsnj.com
Phone: 908-340-0469

Submit Referral