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Submit a Referral

If you are a new client or partnering agency that would like to refer a new client for mental health services, you may use our referral form. Completed referral
forms can be mailed, faxed, or hand delivered using the information found at the top of the form.  Upon receipt of the completed referral form, we will contact you to schedule an appointment.

QCI Referral Form

If you are experiencing a mental health medical emergency, call 911 or go immediately to the closest emergency room.
QCI Behavioral Health, LLC
Prince George’s County
9475 Lottsford Rd, Ste. 250
Largo, MD 20774
Fax 301-636-6509
QCI Behavioral Health, LLC
Southern Maryland
Calvert County
Charles County
St. Mary's County

5010 Regency Place, Suite 203
White Plains, MD 20695
Fax 240-419-2556
Toll Free 855-724-8500
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QCI Behavioral Health, LLP
Washington County
201 North Burhans Boulevard

Hagerstown, MD 21740
Fax 301-791-5032

QCI provides services for English speaking patients at this time. QCI will attempt to direct non-English speaking individuals to appropriate resources to the best of our ability. ​

NOTE: When using the email addresses below, your information is not encrypted. Your responses may be read by others using your Internet service. Please do not include any sensitive information.