Client Referral Form

Thank you for referring someone to Life Centered Therapy. We truly appreciate the trust you place in us when connecting individuals to our care. Whether you are a provider, organization, or loved one, we are honored to support the person you are referring. Our team is committed to handling each referral with professionalism, compassion, and confidentiality.

This form helps us efficiently gather the information needed to move forward with your referral through our intake process, minimizing administrative burden. If you have questions or need help completing this form, please reach out to us at info@lifecenteredtherapy.com – we’re happy to help.