Provider Referral for Counseling Services
If you are referring yourself for counseling, click this button
Thank you for considering a referral to Samata Wellness Solutions. To make the intake and admission process as smooth as possible for you and your patient, please provide the following information on this secure form. Please be assured that this referral will be handled in a way that respects your patient’s privacy and complies with HIPAA regulations. You may also call us at 844-472-6282.
A representative will let you know we received your referral and will follow up with you and your patient within one business day.