Medical Legal Partnership Referral Form

A form for medical personnel participants from partnership clinics (e.g. CHLA, LAC+USC, Harbor, MLK) requesting assistance from the Alliance.

Referring a case to the Alliance for Children’s Rights does not guarantee services or representation.

Please assume your case has not been accepted for assistance until you receive affirmative confirmation from the Alliance that your case has been accepted. Missing information will delay the investigation. Our privacy policy can be viewed here.