Get Started

Convenience is important to us (and to you!), and so we put together two options to get started right away.

In case of a medical emergency, psychiatric crisis, or if you are at risk of harming yourself or others, CALL 911 or seek the nearest emergency room. DO NOT use this form.

To Schedule Your Intake Appointment Use Our Online Scheduler

Once scheduled, you will receive a confirmation email with consent forms, please complete before your intake appointment. Prior to your appointment you will receive an email from [email protected] with a zoom link and instructions on how to attend your intake appointment.

Fill out our agency referral form by using our online submission form or by faxing the form to 916-669-1214. You may also call 888-880-8443.

Download the PDF above or fill out and submit online through the forms below:

"*" indicates required fields

Referring Department*
Confirmed Telemedicine Capabilities

Complete the following if patient has a prescription for controlled substances and/or long acting injectables.

Controlled Substances (PCP contact information)

Long Acting Injectable Rx (Pharmacy information)

Patient Information

MM slash DD slash YYYY
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

Once the referral is received, a care navigator will contact the patient to get started.

Athena Portal

We’re using athenahealth to help you access your health information and manage your treatment. Click below to get access to the portal.

We’re here to help

Contact Us888-880-8443