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KCBSFast Referral

No account required

Direct provider referral

Refer a client in under one minute.

Enter the essentials. KCBS will follow up for anything else.

🔒 Encrypted submission directly to KCBS

1

Referring professional

How can KCBS follow up with you?

Your nameAgency or organization

Work emailDirect phone

Website

2

Client

Who are you referring?

First nameLast name

Date of birthMedicaid ID (optional)

3

Parent or guardian

Who should KCBS contact?

Full name

Mobile phoneEmail (optional)

4

Referral

Tell us what support is needed.

Primary concernShort note (optional)＋Take photos or choose documentsInsurance card, ID, referral, or other supporting fileI confirm that I am authorized to submit this referral and securely share this information with KCBS for care coordination and intake review.

Protected information is available only to approved KCBS intake staff.

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