Referral & Intake Screening

If you would like to refer a client to Mindfully At Peace, PLLC for outpatient psychotherapy services, please complete the referral form below. To help us process the referral efficiently, please provide as much information as possible and upload any relevant documentation when available.

If a recent Comprehensive Clinical Assessment (CCA) has been completed, we encourage you to include it with the referral. If you have any questions or would like to discuss a referral prior to submission, please feel free to contact us. We look forward to partnering with you in supporting the client's healing and wellness journey.