Fax or E-mail

Download, Print and Complete our simple Referral Form, and Release of Information forms. Once completed, you may either fax to 602-788-1119 OR scan and send via email to  Maricopa-info@azbcinc.com

with subject line: Referral Form. (Please note our forms are in .pdf format and will require a pdf viewer. If the computer you are accessing this form with does not have the software, you can download Adobe Acrobat Reader, for free, here.

For Courts / Probation Officers / Referring Agencies

You may call the administrative office directly at 602-788-1116 to request referral forms. We can customize for your Court to include Court name, address, and phone number on 2-print or 3-print carbon copy forms;
Or you may click below to download and print a single form then fax or email to our office.