Referral | Rise Counseling and Wellness Group | Hagerstown

RISE no background.png

Now accepting Maryland Medicaid & Cigna!

301-778-5900

226 N Potomac Street
Hagerstown, MD 21740

Home
Services
Referral
About Our Team
More

Use tab to navigate through the menu items.

Rise Therapy Referral

Referral source

Email address

Client's Full Name

DOB

Street Address

School & Grade (if applicable)

Parent/Guardian Full Name (if client is under 18 years old)

Phone Number

Insurance Provider & Member ID #

Reason for referral

We appreciate the referral & will be in touch soon!

Contact jess@risecounselingllc.com for questions/concerns

RISE no background.png