Referrals📧 Email: care@elevatementalhealthservices.com📞 Phone: 909-206-2085📠 Fax: 704-286-3171 Patient Information * - Name - Phone - Email - State of residence Referring Provider’s Information * - Referring provider’s name and credentials - Practice/clinic name - Contact information (phone, fax, email) - Reason for referral - Urgency level or preferred timeframe for appointment Message (optional) Thank you!
