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Referral Forms

Referral Forms

Professional Referrals

To make a referral to Columbus Behavioral Center for Children and Adolescents, complete and submit the secure form below. A member of our Admissions department will respond to you shortly.

Help is Just a Phone Call Away

We cannot offer diagnosis, counseling or recommendations online, but an Assessment and Referral specialist is available to schedule a no-cost assessment at 812-376-1711. If you are currently experiencing an emergency, please dial 911 or go to the nearest emergency room.