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The information obtained in this form will be used to help our CARE Program Family Navigators inform clients and families with mental health providers and resources available in your area. Please allow 7 to 14 business days for this process to occur. Once this step is complete, a Family Navigator will collaborate with the family to review their options. Family Navigators will follow-up with families to address barriers that may arise during scheduling and collect feedback on the mental health services they are receiving.

The information in this referral is confidential and protected by HIPAA privacy rules.

You are welcome to leave any of the questions unanswered. You may also enter "I don't know" or "N/A" as responses if needed.

Disclaimer of Warranties and Liabilities

The CARE Program, facilitated by the Indiana Chapter of the American Academy of Pediatrics ("INAAP"), provides information on mental health care services available in the state of Indiana and aims to connect participants to resources available in their area. However, inclusion of a physician, medical practice, counselor, or other mental health care provider is not and does not imply endorsement by INAAP or the CARE Program. It is still the sole responsibility of the participant or their legal guardian to determine whether a listed provider fits the needs of the participant.  Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care plan. NO MEDICAL ADVICE IS BEING PROVIDED THROUGH THIS SERVICE. 

INAAP makes reasonable efforts to keep the information used as part of this program accurate. However, because information changes quickly and can become out of date, INAAP makes no representations or warranties of any nature with respect to the information obtained through program. 

INAAP shall not be liable to you or others for any decision made or action taken by you in reliance on the information obtained from this service. Please indicate your agreement with the terms and conditions set forth above by clicking below on the button labeled "Accept."
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