REFERRALS

If you are another healthcare or mental health practitioner with a client you would like to refer to us, please use the secure HIPAA-compliant form here or download and fax us the attached pdf form.

PDF and Fax

Please print this form and fax it to us at (470) 243-1502

Download PDF Form

Secure Online Form

This form uses encryption and is HIPAA compliant

Go to Secure Online Form