Patient Referral

Thank you for choosing Paradigm Psychiatry as a trusted resource for your patient's needs. Other healthcare professionals and facilities are welcome to refer new patients to our office by simply completing the referral form provided below. Our office will ensure a smooth process by promptly contacting the patient to schedule an intake with the provider best suited to meet their mental health needs.

*Not contracted with Medicare/Medicaid

Patient Information
Please enter the patient's full name.
Please enter the patient's date of birth.
Please enter the patient's phone number.
Please enter the patient's email address.
Referring Provider
Please enter the referring provider's name.
Reason for Referral