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  • Send A Referral

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    Send A Referral

    We welcome your referrals

    We accept referrals from healthcare providers and professionals seeking mental health services for their patients. Our clinical team provides evidence-based care across the lifespan.  We will contact the patient within 24 business hours. 

    How to Submit a referral 

    1. You may direct patients to our Free Consultation Form, where they can schedule a call at a time that works for them.

    If patient consent has been obtained and the patient has agreed to be contacted, you can: 

    2. Send the referral via email: [email protected]

    3. Use the referral form below. 

    In the fields, include:   

    • Referring contact’s name, phone number, and email

    In the body of the message add:

    • Clinic name and location
    • Patient (or parent/guardian) contact information
    • The insurance name, example: “Aetna”, “BCBS” etc.
    • Requested service or presenting concern
    • Any other pertinent information

    This referral form is for non-crisis patients only. If there is any question regarding appropriateness of referral, please contact our office directly to discuss prior to submission.

    By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.