For Healthcare Providers

Refer a Patient to
Mind & Metabolism

Complete the secure form below and we'll contact your patient within one business day to schedule an intake appointment.

HIPAA Secure Form data encrypted & compliant
1 Business Day Response We contact the patient directly
Urgent Referrals Call (253) 525-5536 directly
Referral Form

We Make the
Process Simple

Fill out the form once. We handle the rest — reaching out to schedule, confirming insurance, and keeping you informed.

What happens next

1

You submit the referral with patient and insurance info.

2

We contact your patient within one business day to schedule their intake appointment.

3

We reach back out to you via your preferred method with a status update.

For urgent referrals or questions, call us directly at (253) 525-5536 or fax to (253) 525-5537.

This form is hosted within our HIPAA-covered Google Workspace environment and is compliant for submitting protected health information.