Let’s work together, better
To refer a patient for a mental health evaluation, please download and complete a
Then send a referral packet with a release of information authorization, along with any patient records to us at our secure efax number
1 (800) 446-6048
For patients interested in TMS, copy the link below and forward it to your patient. They will be sent a PHQ-9 that feeds directly into our electronic health record.
https://phq9web.azurewebsites.net/PHQ9/Survey/87180
For patients interested in Spravato (ketamine) therapy, please download the
Spravato patient referral form
complete, and return by secure fax at the number above.
By using these links you agree that you are the provider or provider representative for the patient, the patient has authorized you to disclose their protected health information, and you have read and agree to our privacy policies.