Refer your patients with confidence using our Provider Referral form. Our streamlined process guarantees timely and efficient care coordination, ensuring your patients receive the specialized services they need. Just complete the form with the necessary details, and our team will promptly reach out to follow up on your referral.
This referral form is intended for use by licensed medical or mental health professionals referring a patient for psychiatric consultation or evaluation.
Please fax us current pertinent medical records at 940-365-5722
Patients should not use this form. If you are a patient, please use the “Message Us” chat box (Klara) on the bottom right of the screen for administrative questions or to begin the new patient screening process.
You may also visit our Contact page for more information or to reach our team through the proper channels:
Note: This form is reviewed by our administrative staff and is not monitored in real-time by clinicians. Please do not include urgent or time-sensitive clinical information.
