🌿 REFERRALS

The Healing Porch provides psychiatric evaluations and medication management for adults throughout Florida via secure telehealth.

✔Appointments Available Within 1–2 Weeks

✔Most Major Insurance Plans Accepted

Conditions Treated:

To refer a patient, please complete the secure referral form below. Our office will contact the patient directly to schedule an appointment.

Referring Provider *

Practice Name *

Phone Number *

Fax *

Email address *

Patient First Name *

Patient Last Name *

Patient Date of Birth *

Patient Phone Number *

Patient Email Address *

Front of Insurance Card *

Back of Insurance Card *

Medical Records

Additional Records

Comment