Make a Referral


We appreciate and value your interest in making a client referral to Leading by Example. By referring a client to our program, you have begun a relationship with a network of community servants that are committed to delivering the highest quality care and service.

It is our goal to make the referral and service initiation process as user friendly and efficient as possible. Therefore, we have provided you with 3 easy steps to making a referral below. In addition, we have included a referral form on this site that can be filled out electronically and emailed directly to our Office Manager. Finally we have included a list of things that you can expect after you have successfully referred a client to our program.

At this time we provide services to clients receiving Medical Assistance.

Steps to Making a PRP Referral

Step 1: Speak with client that you will be referring and inform them that you are making a referral on their behalf to Leading By Example for the specific services that you are requesting.

Step 2: Complete either a hard copy or electronic referral form with all necessary client information. Click Here: To Access an Electronic version of our Referral Form

Step 3: Fax referral form to Leading By Example FAX#: 410-780-2694

What you can expect after making a PRP referral

  • Once we have received your referral we contact you directly to thank you for entrusting us with your client, and to confirm that we received the referral.
  • Next, we contact the client or family to schedule a screening assessment.
  • Once the client is screened to ensure that they are an appropriate fit for our services, we will submit for authorization.
  • Client is submitted for authorization of service. This process usually takes 72 hours.
  • Once client is authorized for service we contact you within 24 hours to inform you that services have been authorized.
  • We then contact the client and family immediately to schedule an initial assessment. In addition client is matched to a Direct Service Worker who will be facilitating rehabilitation or behavior modification services directly.
  • Direct Service Worker will contact you to introduce their self and to ensure that you have their direct contact information.
  • After initiation of service, you will receive a monthly summary of your client’s progress with rehabilitation and/or behavioral goals.

Steps to Making a TBS Referral

Step 1: Speak with client that you will be referring and inform them that you are making a referral on their behalf to Leading By Example for the specific services that you are requesting.

Step 2: Complete either a hard copy or electronic referral form with all necessary client information. Click Here: To Access an Electronic version of our Referral Form

Step 3: Attach to the referral form the client’s most recent psychosocial assessment or psychological evaluation.

Step 4: Fax referral form and psychosocial assessment or psychological evaluation to Leading By Example FAX#: 410-780-2694 1 and to TBS Care Manager Value Options FAX#:1-887-502-1004

What you can expect after making a TBS referral

  • Once we have received your referral and the most recent psychosocial assessment, we contact you directly within 24 hours to thank you for entrusting us with your client, and to confirm that we received the referral.
  • Next, we contact the client and family to inform them that they have been referred for TBS Services.
  • We then submit the client’s information to value options for authorization for assessment. This process usually takes 48 hours.
  • Once client is authorized for an assessment we contact you to inform you that our client has been authorized for assessment. We then contact family to schedule an appointment for assessment.
  • Once the assessment is completed, we submit it to value options for authorization of service. Authorization for service generally takes 48 hours.
  • Once services are authorized, we contact the referral source and the family to inform them that they have been authorized for TBS service. Immediately following, A Therapeutic Behavioral Aide is assigned to the case.
  • Next, the Therapeutic Behavioral Aide contacts the family immediately to schedule an intake meeting and to execute the intake process. It usually takes 3 business days to schedule and complete the intake process.

Steps to Making a TCM Referral

Anyone may make a referral for TCM services; it is not limited to the client’s mental health therapist, as persons being recommended for TCM may not currently be connected to an outpatient therapy provider. However, the client must have a mental health diagnosis given by a previous provider. It is not necessary for a client to currently be insured to obtain TCM services; if a client is uninsured, we can support the client in the application process for Medical Assistance.

Step 1: Speak with client that you will be referring and inform them that you are making a referral on their behalf to Leading By Example for the specific services that you are requesting.

Step 2: Complete either a hard copy or electronic referral form with all necessary client information. Click Here: To Access an Electronic version of our Referral Form

Step 3: Have the client sign the Release of Information located on the last page of the referral.

Step 4: Fax referral form to Leading By Example FAX#: 410-670-3010.

What you can expect after making a TCM Referral

  • Once we have received your referral we contact you directly to thank you for entrusting us with your client, and to confirm that we received the referral.
  • The next step depends on whether the client receives Medical Assistance or is uninsured.
  • If the client is insured, we will submit for authorization.
  • If the client is not insured, a Clinician will contact the client to gather additional information necessary to complete the uninsured authorization forms.
  • The authorization process usually takes 72 hours but may take up to 2 weeks.
  • Once client is authorized for services, we contact the client within 24 hours to inform them that services have been authorized and they have been assigned to a Case Manager.
  • Case Manager will contact client to introduce their self and to schedule the initial intake.

Steps to making a SUD referral:

At this time, we provide services to clients receiving Medical Assistance and provide self-pay options.

Although it is not mandatory to make a referral to secure authorizations for SUD, it can help the administrative process with obtaining the appropriate information in order to submit an initial request. Clients ARE able to “refer” themselves, and/or walk into the clinic to receive services. In this instance, a referral screening and referral form can be completed by the administrative coordinator, with the client.

After an initial authorization request has been secured for client, SUD will move forward with completing client intake process and initial assessment conducted by our licensed therapists/social workers.

SHOULD YOU REFER YOUR CLIENT TO SUD at LBE:

Step 1: Speak with client that you will be referring and inform them that you are making a referral on their behalf to Leading By Example for the specific services that you are requesting.

Step 2: Complete either a hard copy or electronic referral form with all necessary client information. Click Here: To Access an Electronic version of our Referral Form

Step 3: Fax referral form to SUD at Leading By Example FAX#: 443-660-7128
Call to speak with staff at 443-660-8011
OR you may walk in to the clinic. Walk ins and self-pay options available.

“Be an Example of Positive Change”


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