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Struggling or in crisis? Call or text 988 any time. In an emergency, call 911.

Refer a patient

We accept referrals from primary care providers, pediatricians, therapists, schools and hospitals for patients of all ages.

Online referral

Sent securely to the practice. Questions? Call (848) 801-9248.

Your details
Patient

Or write self-pay.

How soon should the patient be seen?

Current medicines, relevant history and what you are asking us to do. You can also fax notes.

For a psychiatric emergency, do not use this form. Send the patient to the nearest emergency department or call 911.

Or fax (973) 218-5091.

988Crisis: call the Suicide and Crisis LifelineCall officeBook online