Make a Referral

Thank you for trusting Caring Therapists with your client's your mental health needs. Please fill out the form and someone will be in contact with your referral. We have offices in Davie, Pembroke Pines, Fort Lauderdale, Sunrise, Coral Springs, Wellington and Palm Beach Gardens and offer telehealth through the state of Florida.

Broward: 954-378-5381

Palm Beach: 561-223-1066

info@caringtherapistsofbroward.com

Name of person making the referral *

Email of person making the referral *

Name of person being referred *

Email of person being referred *

Reason for referral *

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Yes, I want to submit this form & agree to the terms of use. *