Therapy Referral Forms
For Medical Providers
Thanks for recommending our practice.
Medical providers, please submit a completed therapy referral form for each individual patient via email or fax: 980-938-6088.
Please include any additional relevant medical records that will assist our clinicians in accurately assessing the patient and forming appropriate treatment plans.
If you have any questions about patient referrals, the therapeutic services we provide, or our clinicians, contact us.