Thank you for considering Altered Mind for your patient's care. Please complete the brief form below to submit a referral. We will review the referral and typically contact the client within 1–2 business days.
Who can use this form?
This referral form is intended for physicians, nurse practitioners, physician assistants, therapists, case managers, and other healthcare professionals referring clients for outpatient behavioral health services.
Referral Form
Emergency Notice
Do not use this form for psychiatric emergencies or if the client is at immediate risk of harm to self or others. Call 911, direct the client to the nearest emergency department, or contact 988.
Questions about a referral?
Phone: (561) 570-4810
Email: Ryan@altered-mind.com
