For Physicians/Clinicians

Please download the below form, fill it out and send it to us via email or fax. One of our Intake coordinators will promptly respond to you to address your current needs. (click on image)



Once we receive a referral, one of our coordinators will contact you within 24 hours to update you on the status of staffing the request.

You may also call our office and speak with one of our intake coordinators at:

Houston Area: 281-692-9559

Austin Area: 512-431-4721

Dallas / Ft. Worth  817-345-7530