Referring Provider Instructions

  1. Review guidelines
    To ensure that your patient receives the best possible care, please review the referral guidelines below and submit the requested information with the online referral form.

  2. Download and complete referral form
    Complete the online form and go to Step 4, OR download and complete the following paper form.

  3. Fax form: 832-825-9315

  4. Provide patient with scheduling instructions

  5. Please allow up to 10 business days for the referral to be processed.

If you have questions, please call this clinic directly at 832-822-1900.

Referral Guidelines

Other Information

If you are a referring provider’s office needing assistance, please contact the Provider Connect team, M-F 8a-5p, excluding holidays:

  1. Phone: 832-TCH-CARE (832-824-2273)
  2. Toll-Free: 877-855-4857
  3. Email: