Refer a Patient for comprehensive care for depression and anxiety

How it works:

  1. Fill out this simple form.

  2. We'll reach out to your patients to get them scheduled.

  3. We'll keep you updated on your patient’s treatment progresses*.

    * subject to patient consent

Coordinated communication:

We’ll send you a fax after their first appointment followed by quarterly updates as their treatment continues*.

* subject to patient consent

  • Provider's name and contact information

  • Diagnosis

  • Treatment plan

  • Medications prescribed

  • PHQ-9 and GAD-7 score

We’ll also let you know if for any reason we weren’t able to reach your patient or needed to refer them elsewhere.

Patient Info

Provider Info

(Optional)

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