INTERFACE Interest Form

If you are already a member of one of our subscribing communities and are  seeking a referral for mental health services, please call the Helpline, 888-244-6843 (toll free) Mon/Wed/Fri from 9am – 5pm  or Tues/Thurs 8am-6pm to speak with one of our counselors.  If you are not a member of a subscribing community, we suggest reaching out to your Insurance Company or your PCP for referral information.

If you are a provider seeking to join our service to receive referrals or are already a provider seeking to update your profile, please click on the links to complete that process.

If you are interested in your community becoming a subscribing community of INTERFACE Referral Service, please complete this form to receive an information packet via email. Please note that sometimes our email may be in your junk or spam folder. We thank you for your interest and look forward to connecting to discuss this opportunity further!