Intake/Referral Form

Potential participants must meet certain criteria for admission into the MSS program. All prospective participants shall undergo an assessment process to determine if they meet the admission criteria for Morgan Support Services. The Clinical Director in conjunction with the Executive Director shall have the final authority regarding admissions acceptance.




The criteria for acceptance into the MSS program shall include, but not be limited to:

  • Must reside within the MSS service area
  • Must meet state eligibility requirements for the program, generally determined by the Care Coordinator OR have a private payor source.
  • Must have transportation to the MSS facility (funded through MSS)


Exclusionary Criteria


Criteria for excluding a person from service may include, but not be limited to:

  •         Person resides outside of service area
  •         Person does not meet state program eligibility requirements
  •         Person does not have a payor source
  •         Person does not have transportation to the MSS facility
  •         MSS does not have qualified staff/resources to serve the person
  •         Person is an identified criminal offender


If a person is accepted for admission but there are no slots available in the service program requested, the person will be offered a spot on the Wait List.

Interested in making a referral?  Please download the Referral form, complete and fax to Attn: Rita Quinn, Clinical Director

Morgan Support Services Intake-Referral Form
What other services is this person receiving from what other agencies?

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