Camelot Referral Form
MAKE A REFERRAL
Know someone who would benefit from our services? Complete our Camelot Referral Form and an Authorization to Release Information Form, and our Camelot Psyckes Consent Form then use the option below to upload these forms. If you prefer, you can also email it to us at firstname.lastname@example.org or fax it to 718-981-9344.
ONLINE REFERRAL FORM
Complete our quick online referral form and a staff member will be in touch to provide/request further information.
Camelot of Staten Island, Inc.
Address: 4442 Arthur Kill Road, Suite 4
Staten Island, NY 10309