If you are a medical provider or community support organization and would like to make a community referral for a pregnant women, infant, or caregiver of a infant, please download the Connect Referral Form and fax to (850) 833-9484.

 

Click HERE for Referral Form

 

For more information or questions, please contact your local Connect Representative.

CONNECT Coordinated Intake & Referral PHONE:
850-833-3999

CONNECT Coordinated Intake & Referral FAX:
850-833-9484

CONNECT Coordinated Intake & Referral EMAIL
gisselle@hsow.org