Connecting your client/patient couldn’t be easier. Here’s what the process looks like:

During your client’s/patients visit complete the required information below (basic and quick)
If you’d like me to know more about you or the person you are referring, complete the optional information
Indicate whether you’d like to be cc’d on the email, and if so include your email address
Hit send. Within 24 hours I will be in contact with your patient/client.

It’s that simple. Together we are providing an integrative approach to care. Thank you for your partnership.

Referring provider

Please include your full name, title and name of practice

Patient/Client Name

First Name

Last Name

Patient/Client Email Address

Would you like to be cc'd on my initial contact with this person?

Include your email below if you'd like to be cc'd.

Yes

No

Provider E-mail Address

You will be cc'd on the initial client/patient email

Message

If you'd like to tell me a little bit more about your client/patient you may do so here or leave blank

Would you like to be added to my email list?

Keep your clients/patients informed by receiving my Sunday emails.

Yes

No

Refer Client or Patient