Client Referrals & General Inquiries

Thank you for your interest in A Mindful Care!

Whether you're a case manager looking to make a referral, a family exploring services, or someone with a general question, we're happy to connect with you.

Please complete the form below, and a member of our team will follow up with you. We look forward to learning how we can help.

Which service are you inquiring about?

Referring Agency/ Organization or Person

First name

Last name

Email

Phone

Confidentiality Notice: This form is for initial referral inquiries only. Please do not include client names, dates of birth, Medicaid numbers, diagnoses, or other confidential information. Our team will contact you to discuss the next steps securely.

Questions or Additional Information ( No Confidential Details)