If you would like to refer a family for WCHAP for services, you may download our referral form by clicking the “DOWNLOAD FORM NOW” button below, and fax the form to (313) 659-3289.  Or, you may submit your referral online using our NEW secure “Online Referral Form”!  If you are physician who is interested in learning more about becoming a family centered medical home or to join WCHAP, please contact us at (313) 863-CHAP (2427) or click here to send us an email.

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