Private Pay or Out-of-Pocket Fee for Services

Please contact us for information on the following services:

Referrals by Service Type

If you would like to make a referral, please use the link by clicking on the desired service to download our referral form. You may email or fax a copy of the completed referral to the following destinations:

Fax: (850) 665-0123


When emailing referrals, it is recommended that you password protect the document or send it encrypted to protect client information.

​You may also contact us with questions regarding an appropriate referral for the service you are looking for. See our "Contact Us" page for details.