Client Referral Form

Thank you for trusting Pasadena Villa Outpatient with your client’s care. 

To begin the referral process, please complete the secure online form below. This helps ensure we have the clinical and logistical details needed to streamline the admissions experience.

Please send records via fax to 424.416.7238 or email admissions. Our goal is to collaborate with referring professionals to deliver timely, personalized care that supports long-term healing.

After you submit the referral form:

Submitting clinical records

To support a smooth transition into care, we welcome all relevant documentation, including: