The referral form below can be downloaded and completed by physicians and doctors to refer their patients who require mental health support.  This form can also be downloaded by clients with IFHP coverage who are seeking therapy.  IFHP clients should have their physician fill out the referral form before scheduling sessions with us.  The doctor or physician can fill out this form and email to info@aolcounselling.com

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For further information, you can email info@aolcounselling.com or call (289) 625-5216