BACH
  • Home
    • Who We Are
    • Board
    • Calendar
    • Contact Us
    • Jobs
  • ECI
    • Program Description
    • Referral Form
  • Buster's Kids
    • Program Description
    • Referral Form
  • Events
    • Fundraising
    • Fishing Tournament
    • Annual BACH Luncheon
    • Just for Kids
  • Donate
  • Resources
  • Giving Tuesday
  • COVID-19 Information
  • Ugly Sweater Contest
How to Refer
Anyone can refer a child to Buster's Kids including concerned parents, grandparents, or caregivers. A referral from a physician is not necessary depending on your insurance. Please provide a prescription form from your physician and a parent consent form in order to receive necessary medical records for pre-authorization processing. Please see necessary forms in the attachments below. Once completed, please e-mail to lmartinez@bacheci.org.
Refer by filling out the form below or calling Buster's Kids at 979-849-2447 or toll free at 877-714-1766.

    ​buster's kids referral submission form




    Referral source information

Submit
For additional information contact sbriones@bacheci.org
prescription_request_form.docx
File Size: 65 kb
File Type: docx
Download File

consent_of_release.docx
File Size: 62 kb
File Type: docx
Download File

Proudly powered by Weebly
  • Home
    • Who We Are
    • Board
    • Calendar
    • Contact Us
    • Jobs
  • ECI
    • Program Description
    • Referral Form
  • Buster's Kids
    • Program Description
    • Referral Form
  • Events
    • Fundraising
    • Fishing Tournament
    • Annual BACH Luncheon
    • Just for Kids
  • Donate
  • Resources
  • Giving Tuesday
  • COVID-19 Information
  • Ugly Sweater Contest