Referral Application Form 5.2023.pdf

WINGS will need to obtain collateral information on each potential client.  This information is usually a Chemical Dependency Assessment, Mental Health Assessment (commonly called a Diagnostic Assessment) or a Substance Use Assessment.  These are completed by licensed professional.

  • What is a Assessment/Rule 25?

An Assessment/Substance Use Assessment is an interview with a Licensed Professional that is designed to assess an individual substance use history to determine what level of care would best meet the individual's needs.  Substance Use Assessments are only valid for 45 days, after which time an update is required. 

If you have not had any type of assessment completed, Wings will also do a Substance Use Assessment, however we do charge to have this done. It will be your responsibility to submit those charges to your insurance company.

  • What do I do after the assessment is completed?

Once the assessment has been completed, have your  assessor fax (320-316-2383) or email the assessment to Once your assessment has been received by WINGS it typically takes 2-3 business day for our clinical staff to review the information.

  • Is there any other information I should send to WINGS?

Please sendExternal link opens in new tab or window External link opens in new tab or windowReferral Application Form (link is found at the top of this page.  Complete the form and print a copy) along with a copy of the most recent CD assessment and a copy of a Diagnostic assessment if one has been done.

Please fax this information to WINGS at 320-316-2383 or E-mail to 


After reviewing your assessment and the clinical staff has made a determination if you are appropriate for the WINGS program, our staff will contact you to schedule a phone interview.  The interview is an additional screening tool that we use to determine if our services can meet your needs.  It is VERY important that your contact number is on the referral information and current.