Make a Referral for Treatment

Our team is happy to work with other physicians, therapists and other behavioral health professionals to get a client or patient into the right treatment program for their needs. If you’re looking to refer your patients or clients to Coral Shores Behavioral Health, please fill out the secure, confidential form below and someone from our team will reach out to you in a timely manner. If you have further questions, give us a call at 772-403-4000.

If you need to fax hard copies of documents to us, please send it to 772-361-6213.

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Practitioner Information

Office Name*

Practitioner's Name*

First Last

Contact Name*

First Last

Phone*

Fax

Client Information

Patient Name*

First Last

Patient Phone*

Date of Birth*

Insurance Type*

Policy Number*

Referral Information

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Reason for Referral/Admissions*

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Here When You Need Us Most

Whether you’re struggling with mental health or addiction issues, the staff at Coral Shores is here 24 hours a day, 7 days a week to get you the help you need to recover. Start your no-cost, confidential level-of-care assessment today by calling (772) 403-4000 or visiting our Stuart, Florida location.

In the case of a medical emergency or crisis, please dial 911 or go to the nearest emergency room.

Make a Referral for Treatment

Practitioner Information

Client Information

Referral Information

Here When You Need Us Most

Admissions

Help and hope are closer than you think.

Coral Shores Behavioral Health

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