Please note that all of our services have transitioned to teletherapy. We are accepting new referrals for all services. Please indicate in the referral form if there are any barriers to receiving services via teletherapy. Click to read more about our agency’s response to COVID-19 and our teletherapy platform.
This page gives you two convenient options to submit a referral.
WEB BASED FORM – Use our convenient and secure Web-Based Referral Form to submit all your information directly through the web-browser. OR
PRE-FILLED PDF – If you have already completed our fillable PDF Referral Form – you can upload that by clicking on the “Pre-Filled PDF Referral Form Submission” below. You do not have to complete the web referral if you’ve filled out the PDF. You will upload the PDF to this form. Click the link if you’d like to download our PDF Referral Form There is a button at the end of the PDF form to submit the form. It will bring you back to this page to upload it once complete.