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Refer Your Client with Confidence

We provide warm, high-quality mental health care for individuals, couples, and families.

Submit a referral below and our team will follow up directly with your client. 

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Please complete the referral form below with as much detail as possible.

What to Expect

Contact

Contact within 1–2 business days

Service

Services in Powder Springs, GA and via telehealth

Options

Individuals, couples, families, ADHD support

Payment

Payment: self-pay (FSA/HSA accepted) or insurance

We are honored to partner with you in your client’s care. Please use this form to securely share referrer and client details, select a preferred therapist, and upload necessary insurance documentation. Once submitted, our team will review the information and contact the client to finalize the intake process.

We're Here to Help

Form

Address

3849 Oakview Drive, Suite 200

Powder Springs, Ga 30127

Phone

678-789-9237

Referring Provider Information

Client Demographics

Clinical & Referral Details

Insurance & Payment

Payment Type
Upload Image
Upload supported file (Max 15MB)
Upload Image
Upload supported file (Max 15MB)

Client Needs

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