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Easily Refer Your Patient for Specialized Psychological Care

Partner with us to ensure your patients get expert, evidence-based mental health care. Our team of licensed psychologists offers tailored treatment for anxiety, depression, trauma, chronic health conditions, and more. Complete the form below to start the referral process — we’ll take care of the rest.

Two doctors reviewing paperwork wearing white lab coats. They are preparing the referral form to send their patient for specialized psychological support from Rowan Center for Behavioral Medicine

Thank you for your interest in referring to the Rowan Center for Behavioral Medicine.
If you would like a paper copy of this referral, please e-mail us at consult@rowancenterla.com

Healthcare Provider Referral

Patient Information

Patient Name
Patient Name
First Name
Last Name

Referring Physician Information

Name
Name
First Name
Last Name

Reason for Referral

Please check as many as apply to provide our center with information regarding your patient's needs:

Feedback and Contact

Preference for feedback regarding referral:

If you have any problems with form submission, please download the PDF version and e-mail it to consult@rowancenterla.com.

This form is HIPAA-compliant