We value your privacy

We use cookies to enhance your browsing experience, serve personalized ads or content, and analyze our traffic. By clicking "Accept All", you consent to our use of cookies.

Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.

  • Have Questions? Call or Message Us! Phone Number: 855-209-2690 Fax: 855-209-2840 Email Address:
  • Address
    2364 Woodlake Drive, Suite 170 Okemos, MI 48864
  • Hours Operation
    • Monday-Friday
    • 8:00am - 5:00pm
    • Sat | Closed
    • Sun | Closed

Step 1Select the Appropriate Treatment Referral Form

Select your referral from the box below.
If you do not see the correct form, please call 855-209-2690

If you’re having trouble displaying the form on a mobile device
please make sure pop-up blockers are disabled.

Step 2Submit Your Referral via Fax

Please do not email referral forms

Fax: 855-209-2840