Refer a Client

Thank you for trusting Embrace Wellness with your referral. We welcome referrals from physicians, therapists, school counselors, and other providers. Our team offers trauma-informed care to individuals, couples, and families across Colorado.

You can submit a referral using the secure form below or reach us directly by:

Phone: (719) 499-4880

Fax: (719) 258-1469

Email: admin@embracewellnesscs.com

Referring Provider Section:

Referring Providers Name*

Title/Role

Organization Name

Email

Phone

Referral Source*

Client Section:

Client Full Name*

Client Date of Birth

Client Phone*

Client Email*

Parent/Guardian Name (if under 18)

Presenting Concerns / Reasons for Referral*

Preferred Contact Method*

Preferred Appointment Type*

Preferred Therapist

Insurance Provider

Aetna

Anthem/BCBS

Kaiser Permanente (Carelon Behavioral Health)

Cigna

Medicaid

Medicare

TriCare

United Health Care/Optum/UMR

Other

I confirm that I have obtained the client’s consent to share their information with Embrace Wellness Counseling Services for the purpose of initiating services.