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Refer a Client, Family Member, or Friend
Help clients, friends, family, or colleagues access convenient, compassionate mental health services.
Simple and Secure Client Referrals
To make a referral, call us at (503) 217-4455 or submit the form below
Your Name
*
Phone number
Email address
*
Referrals Name
*
Referrals Phone number
Referrals Email
*
*
Please select at least one option.
I confirm that I have obtained the referred individual's consent to share their information with Synchronous Mental Health. I understand that this referral form is not for emergency situations.
*
Please select at least one option.
By submitting this form, I acknowledge that Synchronous Mental Health may contact the referred individual to offer services and that this form is intended for non-emergency referrals only.
Submit
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