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Family Center For Behavioral Health

Contact Family Center For Behavioral Health

Click to Call: (253) 851-3808

Referrals

Physicians/Health Care Professionals

If you are a physician or other health care provider, we are pleased to accept new referrals from your practice. We will promptly respond to referrals and the individual patient’s treatment needs. We will collaborate with you to achieve the highest quality, cost effective, and timely patient care. Please have the patient or your office call us at 253-851-3808 or complete the following form. This information will help the triage process and assure the best therapeutic match for your patient. Providers at the Family Center for Behavioral Health are affiliated with most local and national health care insurance plans. Day and evening appointments are offered.


Your Contact Information

*Referred By:

*Phone:

*E-Mail:

Patient Information

*Patient Name:

Contact Name:
(If Patient is a minor)

*Date of Birth:

*Patient Phone:

Insurance Co:

*Preferred Provider:

*Present problem/
diagnosis:

*Choose an option:
How did you hear about this provider?

*(required)

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