Atlas Behavioral Wellness – Referral Form
Thank you for referring to Atlas Behavioral Wellness.
This form is intended for care coordination and referral purposes. Please include only the minimum necessary information. Avoid sharing highly sensitive protected health information (PHI) unless required. Our team will follow up within 1–2 business days.
- FAQs
Frequently Asked Questions
Find answers to common questions about the Atlas Behavioral Wellness referral process. This section provides guidance on submitting referrals, required information
Select Routine, Moderate (within 1–2 weeks), or Urgent (ASAP) based on clinical judgment and client needs. For emergencies, clients should contact 911 or local crisis services immediately.
If additional information becomes available, the referring provider may contact Atlas Behavioral Wellness directly to provide updates or clarifications.
All submitted information is handled in accordance with applicable privacy and confidentiality standards and used solely for referral review and care coordination purposes.
Urgent referrals marked “ASAP” are reviewed immediately, and the care team will contact the client as quickly as possible to arrange services.
Client referral information is retained in accordance with applicable privacy and record retention policies and is used solely for care coordination purposes.
Select “Other” and specify the language in the “Additional Notes” section to ensure appropriate support is provided.