ELECTRONIC REFERRAL SUBMISSION
Electronic submission not available at this time. Please use the fax process, or click the link below to email your referral form with any supporting documentation.
Click here to email supporting documentation
FAX REFERRAL SUBMISSION
To submit the referral form by fax, click the PDF link below to open and print the referral form. Once completed, please fax the form, and any supporting documentation, to the number indicated on page two of the form.
WBC_client_referral_face_sheet.pdf (44.7 KB)
Upon our receipt of the referral face sheet, the information is reviewed and the client is assigned to a therapist. The therapist will then make contact with the person listed on the referral form as the first point of contact.
If contact is not made by someone from WBC within 48 hours of submitting the referral, please contact the office to ensure that your referral was received.