Referral Form

Fill out our secure & HIPAA-compliant Referral Form to connect with Active Path Mental Health. 

Referral

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Provider Name
Provider Name
Name of Referring Provider
Name
hipaa-compliance

“I highly recommend TMS to anyone with depression. [Active Path Mental Health] took care of making sure I qualified for treatment, dealing with my insurance, and all the other things that needed to come together for me to receive treatment. If I was the one in charge of all that, my anxiety would have made it impossible.”

how it works

Quick Guide to Patient Referrals

Refer Your Patient

You’ll refer your patient via an online form or fax.

Free Phone Consultation

We’ll reach out to do a free phone consultation and verify their benefits.

We Schedule an Evaluation

After we’ve gathered info, we’ll schedule them with a provider for an evaluation.

Prior Authorizations

If your client is a good candidate, we’ll handle all of the prior authorizations and get them into treatment once approved.

Treatment Progress

You’ll receive a summary after TMS or SPRAVATO treatment. Feel free to call our main line at any point to schedule a coordination of care call.

Quick Guide to Patient Referrals

insurances we accept