SEND A REFERRAL
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This form is for individuals, leaders, or companies who want to refer someone for counseling, deliverance, or consultation.
Once a referral is submitted, all communication, scheduling, and care will take place directly between the client and the Counseling, Deliverance, RN.
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Referrals are welcomed and appreciated. Once a referral is made and the individual engages services; counseling and care are conducted independently.
To protect confidentiality, spiritual applications, and the counseling relationship, referral sources do not participate in sessions, treatment decisions, or ongoing case discussions unless explicitly requested by the counselor.
All information submitted through this form is kept strictly confidential and will only be used to evaluate and process the referral. Your privacy is fully respected.