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New Referral and Patient Forms

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Facility Referals

If you are a facility and you want to start the intake process, please complete the referral form, and one of our intake specialists will get back to you within 2 Days.

Facility Referal Form
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New Patient Form

Platinum Psychology Services is accepting New Individual Office Patients and New Facility Clients. Feel free to complete the New Patient Registration form here.

New Patient Form