Referral Source Categories

Advertising: Billboard
Advertising – Billboard (includes bus and mass transit advertising).
Advertising: Mass Media
Paid advertising via print (newspaper, magazine, etc), Yellow Pages ad, television or radio

Advertising: Other
Any paid advertising that does not fit in the above specified categories.
Source: ___________________

Flyer / Brochure / Signage
Your program’s brochure, tear off flyer, other promotional or marketing material created and personalized for your program. This category also includes exterior signage of your program, H.E.R.O/LifeSaver Programs referrals, etc…

Healthcare Provider
Physician, Social Worker, Private Practice, Psychologist, Counselor, in private or group practice, Pain Management Clinic. Buprenorphine Prescriber (OBOT)

Hospital / Medical Facility
Any general medical/surgical or psychiatric hospital, emergency departments, urgent care centers and walk in clinics.

Human ServiceOrganization
Community Mental Health Centers, Public Health, DSS, DHS, or any other social service type agency including Homeless Shelters, Food
Pantries, Needle Exchanges, CPS, Salvation Army, Goodwill, Faith-Based Organizations, etc…

Insurance Provider
Referrals from an insurance provider, case manager or if a patient stated that they heard about your program form their insurance provider. For example: Kaiser, Optum, VA covered individuals, etc.

Internet / Website
Internet or website referral. This category includes contact submissions forms from our website and Facebook.

Judicial / Legal
Courts, drug court, police, probation, parole, and attorneys. Any representative in the legal / judicial field.

Modality Change
For programs with multiple services, use this category when a patient moves from one program to another within the same center. For example: Detox to Maintenance or Methadone Maintenance to Buprenorphine.

Other OTP Transfer – Competitor
Patient transferring in of an ACTIVE patient from another OTP including a BayMark program.

Readmission
Readmission of a former patient from the same program.

Support Groups / 12 Step
Support groups or traditional 12 Step programs such as AA & NA.

Word of Mouth
Word of Mouth referrals are from family, friend or an active or prior patient. For example someone may say, “A friend of mine is on the program” or ‘A former patient told me you could help’.

Revision 1/26/2017