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Patient Portal

treatment services

make a referral

make a referral for treatment services

Are you a referral source interested in partnering with our organization? Look no further! 

Our family of trained professionals are here to help. 

Submit a Referral

PATIENT INFORMATION

Do not enter the patient's full name.
Services Needed *
Does the patient have insurance? *
Is the patient Spanish speaking only? *

REFERRAL SOURCE INFORMATION

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make a referral if...

  • You are representing a client from an organization
  • You are a case manager
  • You are a probation officer
  • You are a relative looking to find help for someone
  • You are looking to partner with us

Please Note: If you are an individual in need of treatment services, please click here to request an appointment.

What to Expect

  • After requesting an appointment, someone will be in contact within the next 24 hours.
  • If you are a referral source, the client will be contacted first before someone gets back to you.
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