Referral Intake Form

Tell us about your needs and preferences, and we'll connect you with the right therapist in the Pasadena area.

Client Information

Referral Details

Practical Info

What Happens Next?

After you submit this form, our team will carefully review your needs and preferences. Within 1-2 business days, we'll send you personalized therapist recommendations via email, including therapists who match your specific requirements for therapy type, session format, and payment preferences.