Please fill out this form and click submit form. We will 

contact the new referral within 1 business day and notify you within 4 business days whether or not the appointment was made.


If you need a copy for your record please click print form before submitting.



If you have any questions or concerns please call us at (706) 843- 6241.

Administrative Office Information

Monday-Friday: 8:00am - 6:00pm

Phone: (706) 843-6241

Fax: (706) 843-6242

Therapy Hours

Monday-Saturday: 8:00am - 8:00pm

Correspondance Address

PO BOX 7660

North Augusta, SC 29861

Augusta, Georgia Office
2609 Commons Boulevard
Augusta, GA 30909

If you are having an emergency please call 911. For a non-emergency crisis please call the Georgia Crisis and Access Line at (800) 715-4225.