Making Referrals To Us Just Got Easier!

The provider referral form below is to be completed by providers in the community such as social workers, counselors, case managers, psychiatrists, nurses, medical doctors, schedulers, etc.  Our scheduling team will be contacting your client on the same business day that the referral is received. We can get your client scheduled for a same day or next day counseling appointment.  We can collaborate with you, as the referring provider, to inform you of the date, time, and location of your clients intake appointment.

We accept Aetna, Banner Aetna, BCBS, Optum/United Healthcare and Cigna. 

We do not accept Medicare and Medicaid.

Clients you refer must complete and sign a Release of Information that you can attach to the bottom of this referral form.