Lucy

A Behavioral Health Residential Facility

(BHRF)

📞+1 (602) 880-2979 / +1 (480) 699-1679 📠:+1 (602) 926-8678 📧 admin@lucygrouphomes.com

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REFERRALS

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Thank you for Sending Your Referrals!

Referrer (Full Name)
*
Name of the Referring Association (if any)
Referrer’s Email Address
Referrer's Phone Number
*
Referee (Full Name)
*
Insurance AHCCCS ID
Insurance - Health Plan
Referee's Email Address
Referee's Phone Number
Risk Screening (Admission Safety)

Suicidal Ideation (Current)
Homicidal Ideation (Current)
Recent Aggression/Violence
Elopement Risk
Additional note

Providing structured residential support for safe and successful transitions from inpatient care!

Lucy Homes, LLC
📞+1 (602) 880-2979 / +1 (480) 699-1679 |📠:+1 (602) 926-8678

📧admin@lucygrouphomes.com

Lucy

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