making a referral

Referrals can be made by calling our very friendly Intake Coordinator Leticia at 602-253-6259, or by emailing her directly. She will happily answer any questions you may have and assist you with getting scheduled for an initial appointment, which includes a thorough intake and assessment.

Referrals can also be made through member health plans, and other providers and outside agencies. For providers, you can download and complete a copy of our Referral Form below. Just email this completed form to our Intake Coordinator here or via fax at 602-254-1153.

Also, while walk-in appointments are available, we recommend scheduling your intake appointment in advance, as there are times we may not have the availability to see you without an appointment, unfortunately.

For members that meet all criteria, there is no cost for counseling and support services for enrolled AHCCCS members.