Send a Referral

Blueprint Counseling partners with schools, medical providers, courts, and community organizations to connect children, adolescents, and families to trauma-informed, evidence-based care. Referrals are reviewed promptly, intake is coordinated clearly, and collaboration with referring partners occurs as authorized and appropriate. Submit a referral using the secure form below, or contact us to consult on fit before intake.

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If you are from a doctors office, school, government agency, or similar entity, please download referral form and email to info@myblueprintcounseling.com or fax to 336.646.6726

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If you are an individual please fill out the information on the Contact page or email an inquiry info@myblueprintcounseling.com.