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Refer a Client

Welcome to our secure referral portal. At Illuminating Insights, we collaborate with community partners and clinicians to facilitate efficient transitions of care for individuals seeking outpatient therapy.

Whether you are coordinating a transition due to an internship completion, a program change, or assisting an individual in establishing outpatient services, we are committed to ensuring a seamless administrative process.

Prior to submitting the form below, please ensure the client is aware of this referral and has provided verbal consent for us to verify their insurance eligibility and benefits.

Once submitted, our administrative team will verify the client's insurance benefits and contact them directly to complete their billing setup and schedule their initial appointment. Thank you for your referral.

Client Information

Date of Birth
Month
Day
Year

Please provide the client's current residential address.

State

Payment & Insurance Details

Expected Payment Method
Insurance
Self-Pay

Briefly describe how we can help you.

Acknowledgment

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