• 24-hour Crisis line: 1 (800) 584-3578

ASO Information
North Sound BH-ASO
2021 E. College Way, Suite 101
Mount Vernon, Wa 98273
Ph: (360) 416-7013

For Providers / System Partners

For PROVIDERS who are required by law to protect health information and confidentiality, you will need to obtain signed consent from the youth and/or guardian utilizing your agencies release of information (ROI) Form, and attest by clicking the appropriate box below prior to filling out a YNP referral. You will need to submit both your agencies signed ROI and the completed referral form.

For SYSTEM PARTNERS who are not legally required to obtain a signed consent to release information, please ensure you have notified the youth and family that you are submitting a referral to the YNP on their behalf and attest by clicking the appropriate box below. You may be asked to assist YNP staff in obtaining youth and/or guardians' signature on our ROI

You may email these directly to YNP@nsbhaso.org, or feel free to Contact us for other options.

Referral Forms

PROVIDERS - Have you obtained an ROI from the youth and/or Legal Guardian to release the information that is required for this form? If so, please click the checkbox below.



SYSTEM PARTNERS - Have you notified the youth and family that you are submitting a YNP Referral on their behalf? If so, please click the checkbox below.