Referral Form

Please fax all referral forms to (661)231-3153.

Link to psychiatry/therapy referral form

Please note for Spravato referrals that a patient must of trialed at least two different antidepressants from two different classes for at least 6 weeks to qualify for Spravato with most insurances. We are unable to provide Spravato for patients with Tricare insurance at this time.

Spravato Referral Form