Refer a patient.

Thank you for your interest in our program. To refer a patient, please complete the form below, or call us 1-844-292-7372. We look forward to working with you.

Please enable JavaScript in your browser to complete this form.

Referring Clinician

Name

Patient Information

Patient Name
Patient Date of Birth

Next Steps

Aware Recovery Care
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.