REFERRALS

How to Apply For Our Services

 

Your mental health care provider will complete a referral form on your behalf and fax it to our office at 443-272-2664 or our phone on 443-272-2614. We also require your psychosocial information and evaluation to help us to serve you better. 

Please fill out the form below, to send in your referral. If the form below does not open, use the Online Referral Form button, to open the form in a separate window. 

REFERRAL FORM

Online Referral Form