• Care Coordination Referral Form

    The South Dakota Resource Hotline is offering Substance Use Care Coordination to assist individuals by advocating, connecting and supporting their recovery process. If an individual or yourself may benefit from Care Coordination, please complete this form and the Substance Use Care Coordinator will follow up.
  • This program is for South Dakota residents. If you are outside of South Dakota, get connected with local services in your area by dialing 211 or visit 211.org.

  • To help us better understand who we are reaching out to, please provide us with some details.  

    (These should be for the individual seeking help)

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  • I acknowledge that the information I have provided will be used by the Substance Use Care Coordinator for the purpose of coordinating referrals and services.

  • Should be Empty: