Glenn Dallmann
Admissions Coordinator
218.728,7500 x143
800.644.4557 x143
218.728.7501 (FAX)
gdallmann@woodlandhills.org

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Referral Form (pdf | doc)

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> Make a Residential Program Referral

To make a referral to the Chisholm House, Residential Treatment for Corrections, Residential Treatment for Mental Health or Semi-Independent Living, please follow these initial steps:

  1. Contact Glenn Dallmann, Admissions Coordinator (contact information to right)
  2. Download the Referral Form (pdf | doc) and fax to Admissions Coordinator
  3. Provide collateral information to include: assessment reports, social history, disposition report and discharge reports from previous placements

Follow these additional steps for Residential Treatment for Mental Health:

  1. In order to process the referral, the parent of a referred youth is asked to complete and forward the Pre-placement Insurance Form
  2. A copy of the current diagnostic assessment ~ not older than six months ~ is needed by Woodland Hills. It should include a recommendation for residential treatment and verify that the client meets SED (Severely Emotionally Disturbed) standards.