REFERRAL Form

Thank you for considering My-Therapist as a trusted resource for care. Whether you are referring yourself, a loved one, a client, or a patient, we are honored to help connect you with meaningful support.

My-Therapist provides specialized therapy for individuals, couples, families, and teens, including couples intensives and EMDR therapy. Please complete the form below, and our Client Care Coordinator will follow up to discuss next steps, availability, fees, insurance options, and the best fit for care.

If this is an emergency or urgent mental health crisis, please do not use this form. Call 911, call or text 988, or go to your nearest emergency room.