Transfer Protocols and Forms

DMH Transfer Protocols and Forms

This page contains the clinical criteria and transfer protocols for receiving DMH Facility continuing care services and Request for Transfer Forms. There are separate forms for the transfer of adults and transfer of children and adolescents. 

For contact information, please see the DMH Liaison List For Hospitals. 

Request for Transfer for Adults

• Continuing Care at DMH Facilities/Units: Processes for Referrals 
• DMH Continuing Care Referral Transfer Form for Adults (Word)
  • DMH Continuing Care Referral Checklist  
  • DMH Continuing Care Contact Information 

Request for Transfer for Children and Adolescents

When to Make Referrals to DMH Statewide Services (ACCU/IRTP/CIRT) Infographic 

Effective June 23, 2025, there is a new process with revised forms to refer youth to a DMH Statewide Service (adolescent continuing inpatient care [ACCU], intensive residential treatment [IRTP], and clinically intensive residential treatment [CIRT]).

Now, there is only one Request for Transfer Form (RFT) and a Checklist to Refer Youth to a DMH Statewide Service. Both forms are one (1) page in length. All referral packets will now be sent to DMH Central Office at: [e-mail]

The updated DMH Statewide Services Flow Chart/infographic provides decision-making guidance regarding the new referral process.

The new referral process for Acute Inpatient Facilities to refer youth to a Statewide Service follows:

1. Complete the RFT Form.
2. Complete the Checklist to Refer Youth to a DMH Statewide Service.
3. Submit the RFT Form, Checklist, and necessary documents to DMH Central Office: [e-mail]
4. DMH Central Office will confirm receipt of the referral packet and identify any missing documents within one (1) business day.
5. Once a referral packet is complete, DMH Central Office will notify the DMH Area Screener who will schedule a Screening within five (5) business days of receipt of the complete referral packet.
6. DMH will inform the referring facility of the Screening decision.
7. If a youth is accepted for transfer to a Statewide Service, DMH will identify the receiving service within one (1) business day.
8. Youth will be admitted to a vacant Statewide Service bed within five (5) business days, assuming no unforeseen obstacles to transfer.
9. If a youth is not accepted for transfer, DMH will provide consultation and recommend alternatives. Referring facilities may appeal a denial to the DMH Area.

For training on the new DMH CYF Transfer Screening process, please contact DMH at: [e-mail]

• Request for Transfer to an Adolescent Continuing Care Inpatient, IRTP, or Child CIRT (PDF)
• Checklist to Refer Youth to a DMH Statewide Service (ACCU/IRTP/CIRT) (PDF)
• Request for DYS Transfer to a DMH Intensive Residential Treatment Program (PDF)

Recent Changes to the Child/Adolescent Transfer Screening Process

Changes to the Child/Adolescent transfer screening process went into effect on June 23, 2025. Information about these changes can be found below:

• What Has Changed with the New Referral Process to a Statewide Service (ACCU/IRTP/CIRT)?
• Schedule of trainings to review the new process 
  • NEW - Additional trainings for July and August
• Accompanying presentation for the trainings above