For Providers

For Providers

Please complete our patient referral form to get your paitents on the right track for recovery.
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Patient Referral Form

Please complete this Patient Referral Form.  

If you need help now, call 911, head to an emergency room or call 1-800-273-8255

Are you suffering from any of these debilitating conditions?

  • Treatment resistant¬†depression
  • Suicidal Ideations
  • Post-Traumatic Stress Disorder

Simply provide us your name and phone number and we will  contact you immediately.

We will contact you

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