PROFESSIONAL REFERRALS

Professional Referral Form

Complete this HIPAA-compliant digital form to refer a patient for counseling services.

Professional Referral Form

Affinity doesn't require a professional referral for clients to seek counseling services. However, they can often be helpful. If you are a professional provider who would like to make a referral, you can complete our Professional Referral Form, and we will make contact with the client within 1-2 business days.

PROFESSIONAL REFERRALS

Professional Referral Form

Professional Referral Form

Professional Referral Form

Professional Referral Form

Professional Referral Form

Attention Providers, Our system has not been alternating us to new Faxes. Please use the digital "Pr