Referral Process
For your convenience, you may refer a case in any of the following ways:
1. Telephone our main office at 800-546-9636 with referral information. Refer to
the information sheet on the next page.
2.Fill out our electronic form and
submit:
or,
If you prefer, click the following button to download a copy of the CCM Referral
Form in portable document format (.pdf). You will need to install Adobe Acrobat Reader on
your computer if you do not already have a copy of this free software. You can download
Adobe Acrobat Reader and have it installed on your computer in a matter of minutes and
will find it very useful. Click here to access
Adobe Systems Free download page: Once you have installed Adobe Acrobat Reader,
you will be able to RIGHTclick on the follwing link and Save Target As ... to your
computer, then open our form with Acrobat Reader and print it. CCM Referral Form (.pdf) Complete
referral information sheet and fax to 919-846-4740 or mail to: 118 Wind
Chime Court, Raleigh, NC 27615
3. Contact one of the following Customer Account Representatives directly who
will come to your office for copying and pick up of the referral:
CCM Referral Form Please complete the following form to submit your referral. Hit tab to move to
the next entry field.
You will be contacted within 48 hours by a CCM representative.
