Therapy Referral Form

Your mental health matters. You are making a positive first step by reaching out for support! We are very excited to work with you in achieving your goals. Whether you are working through anxiety and depression, grief and loss, PTSD, addiction, relationship problems or other concerns, we are here for you.

Please provide the following information to request services. One of our therapists will be in contact with you as soon as possible. If you have questions please call us at (308) 237-4085.