Legacy United Insurance Group

Care Coordination Intake

Care referral desk

Document the need. Find the right support.

Complete each step with the caller. The information will be organized into a referral email for specialist follow-up.

What happens next

An intake specialist will contact the caller within 24–72 hours to review options and gather anything else needed.

Step 1 of 5Caller details

Caller details

Who is completing this intake?