PATIENT REFERRALS
For direct referrals from Healthcare Professionals only (e.g., PCP, psychiatrist, step-down from higher LOC, Psychotherapist, LICSW, LMHC):
Please complete and fax THESE forms to submit a referral for your patient/client for outpatient psychiatric care with Towerlight Health and Wellness.
Please do not send protected health information (PHI) through standard email. If you cannot fax the forms, please call our office or complete the web form below to request an email invitation to submit the information through our secure message portal, encrypted by Zix.
Current wait-time for a routine intake appointment is: 7-14 calendar days (updated February 2026). Stepdowns will be seen sooner when specifically requested by referrer.
Referral must include (please attach):
1) Eval/Bio/Psych/Soc (Psychotherapist) or Copy of Physical/labs & med list (Medical/Psychiatry).
2) Signed Towerlight Health and Wellness Authorization for Release of Information form (in link above) for the patient’s care team.
3) Step-down referrals require: A course-of-stay note that includes the presenting event (brief HPI), hospital course, discharge diagnoses, medication changes with rationale, and a discharge safety and risk summary.