Online Referral Form


  • Introduction
  • Online Referral Settings
  • Creating the Online Referral
  • Online Referral Website Configuration
  • Using the Online Referral Form
  • Referral Email Alerts 


Our online referrals feature allows agencies to create online referral forms that can be embedded on their public website! From there, visitors fill out the referral form which is then automatically added to the extendedReach system as a new, pending referral.

The online referral form is intended for cases. If you are wanting to capture possible Foster Family applicants, please use the inquiry form found in Organization Preferences -> Family Web -> Inquiries. 

Online Referral Settings

The online referral form is a Program Report Type that utilizes the Custom Form Builder to ensure for agency customization and to help meet specific program needs.

To get started, go to Program Settings -> Program Report Types -> Add Program Report Type. In the Configuration section, select “Use Custom Form Builder”, once selected, click on “Show Advanced Options” and enable the setting “Online Referral Form (advanced)”.
Image: Online Referral setting configuration 

From there, click on the Custom tab to begin building your online referral form!

Creating the Online Referral

On the Custom tab, use the drag and drop the fields on the right side of the screen into the “Add Fields Here” box.

You can then map certain fields to extendedReach (e.g. first name, date of birth, religion, gender, etc.). To map the fields, click on the “Save to Referral” drop down box and select the appropriate field.

Image: Online Referral form building

Mark certain fields required by checking the box next to “Required”. All required fields will show a highlighted yellow label in the custom form builder.

Image: Online Referral required fields

Field codes can also be used auto-fill text in the custom form builder. Field codes can either be placed in the fields or used as help text.

Image: Online Referral field codes

Once the form has been created and finalized, it’s time to put it to use!

Online Referral Website Configuration

On the General tab of the report settings of your online referral, scroll down to the Online Referral Configuration section.

In this view, you can select a default worker for all incoming, pending referrals.

Image: Online Referral default staff

Underneath the Default Staff setting is the Acknowledgement section. When a new referral submits the form, they can receive a customized conformation message or can be redirected to a URL.
To provide a customized message, click on “Message” and use the message field to create your message.

Image: Online Referral customized message

You can also choose to redirect the user to a different page on your website. To do so, click on the “Redirect to URL” button and paste the URL into the URL field.

Image: Online Referral URL redirect

To add the Online Referral to your website, copy and paste the embedded code into your website where you would like the form to appear.
Those who have knowledge of CSS, can use the “Custom CSS” field to make adjustments to the form such as adding a specific font or background color to match the website.

Image: Online Referral advanced CSS

Using the Online Referral Form 

Once the form has been added to the website, potential referrals can begin entering in their information! When they have finished entering in their information, they will click on the Submit button which will then provide them the confirmation message or URL redirection.

Image: Online Referral live page

Image: Online Referral confirmation message

Once they click on the Submit button, their information is then sent to extendedReach. You can view the new referrals by going to Case Rosters -> Referrals.

Image: New Online Referral 

Looking at the referrals profile on the General tab, you can see all the information that was inputted.

Image: Online Referral general tab

To view the complete form, go to the Case File tab and click on the completed Report.

Image: Online Referral case file

Image: Completed Online Referral 

When a new referral is submitted, the system checks for an existing duplicate pending referral for the same program. If one is found, the new referral form is attached as a report to the existing referral – preventing duplicates.

Referral Email Alerts

Referral email alerts allow you to notify workers or supervisors when a pending referral is entered into the system, and when a referral is accepted or denied.

To set up the email alert, go to Organization Settings > Email Alerts > Add Email Alert.
In the “Alert Event” section, use the “Event Type” drop-down field to select either “Referral Accepted”, “Referral Denied”, or “Referral Pending”.
To be notified of referrals entered into the system using the Online Referral Form, use the “Referral Pending” event type.

Similar to other email alerts, you can then specify who you want to receive that email alert in the “Who should receive this notification?” section.

For more information about email alerts, click here

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