Referral Form


CONTACT

Behavioral Bilingual Services

Ph: 702-451-7542
Fax: 702-450-4239
2255 Renaissance Dr. Suite A
Las Vegas, NV 89119

Providing quality mental health services to children and their families of our community since 2000

If you would like to refer a patient to BBS Counseling, please complete the following referral form and fax it to (702) 450-4239

Referral Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization to Disclose Information Form

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