Washington RMHCCityReferral Form is a secure electronic referral system used by medical providers in Washington State to refer patients to services offered by Rural Mental Health Care Coordination Centers (Races) located in their communities. The form is available in two versions: one for medical providers and one for Races. Medical providers use the form to submit patient information, including demographic data, medical history, mental health assessment data, and insurance information. The Races use this form to request additional information from the medical provider, and to track referrals and outcomes. The form also allows providers to update existing referrals and to track referral outcomes. The Washington RMHCCityReferral Form is an important tool for Washington State medical providers to ensure that their patients receive the best possible care, and for Races to coordinate services for those in need.