Welcome!
Thanks for trusting Hello Mental Health with your referral. We’re a relationally focused group practice offering affirming care for individuals, couples, and neurodivergent clients. Please complete the brief form below so we can connect your client with the right support.Our Practice Coordinator, Andrea, will follow up within 1–2 business days to reach out to the client directly and guide them through next steps with warmth and clarity. Every referral is treated with care and respect.

Referring Provider Information

Provider Name *

Practice Name *

Phone

Email *

Client Information

Client Full Name *

Client Age *

Client Phone Number

Client Email *

Is it OK to contact client directly? *

Yes

No, I will facilitate contact

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.