Personal Referral Form

All information submitted on this referral form is completely confidential, secure and encrypted. After you submit the referral form, you will be emailed a copy for your records.   

Use this link to download a flyer about our outpatient services.  We also have a brochure about Play Therapy that you can download to better understand this type of therapy for children. 

For specific questions about our services or waiting list, please call our intake team @ 336-899-8800 Press 1 or email: intake@famsolutions.org.