Comprehensive Community Services (CCS)

This referral is for Pauquette Center for Psychological Services, CCS contracted services.  This form should be filled out by the county's service facilitator.

Please note that at the end of this form, you will also be prompted to upload the client's CCS Service Plan and most recent Comprehensive Assessment.  There will be an additional prompt to continue on to complete a DBT Comprehensive Referral if applicable.

If you are having problems with this form, please contact our Pauquette Baraboo office at (608) 356-9055 ext. 7164 or email info@pauquette.com.

Thank you.

CCS Referral Form

Comprehensive Community Services (CCS)

This referral is for Pauquette Center for Psychological Services, CCS contracted services.  This form should be filled out by the county's service facilitator.

Please note that at the end of this form, you will also be prompted to upload the client's CCS Service Plan and most recent Comprehensive Assessment.  There will be an additional prompt to continue on to complete a DBT Comprehensive Referral if applicable.

If you are having problems with this form, please contact our Pauquette Baraboo office at (608) 356-9055 ext. 7164 or email info@pauquette.com.

Thank you.

CCS Referral Form