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Referrals & Intake
Making a referral to Envisions of Life is simple. Our dedicated intake team is here to guide you through every step of the process.
Connecting People to the Care They Need
Envisions of Life requires all potential candidates for services to complete a referral form. Download the referral form using the button below and submit it using one of the methods listed on this page.
If you are in need of Outpatient Services such as Psychiatric Assessment or Medication Management, additional forms are required prior to your visit. Download the Medication Management packet using the button below.
All new referrals must have valid insurance information sent prior to your appointment for verification. Our intake team responds to all referrals within 48 business hours. For urgent situations, please call our office directly at (336) 887-0708.
Referral Form
Required for all new clients
Medication Management Forms
Required for Outpatient / Psych visits
Complete forms and submit via fax (336) 887-1085, email [email protected], or bring to your appointment.
Contact Intake Team
- (336) 887-0708
- [email protected]
- Monday – Friday, 8:00 AM – 5:00 PM
Submit completed forms by:
How the Referral Process Works
Submit a Referral
Complete our online referral form below, call our intake line at (336) 887-0708, or fax a referral to (336) 887-1085. Include as much clinical information as possible to expedite the intake process.
Intake Review
Our intake team reviews the referral within 48 business hours and contacts the individual or referral source to gather any additional information needed.
Eligibility & Authorization
We verify insurance coverage and obtain any necessary authorizations. We accept Medicaid, most major insurance plans, and offer sliding-scale fees for those who qualify.
Initial Assessment
The individual is scheduled for a comprehensive diagnostic or psychiatric assessment to determine the most appropriate level and type of care.
Services Begin
Following the assessment, services begin according to the individualized treatment plan developed collaboratively with the client and, when appropriate, their family.
Submit a Referral Online
Complete the form below to refer an individual to Envisions of Life. All fields marked with * are required.
Prefer a paper form?
Download the PDF referral form, complete it, and fax to (336) 887-1085 or email to [email protected]
Insurance & Payment Information
Envisions of Life accepts Medicaid (NC Medicaid and NC Medicaid Managed Care plans), most major commercial insurance plans, and offers a sliding-scale fee schedule for uninsured or underinsured individuals who qualify.
Insurance coverage varies by service type. Please contact our billing team at (336) 887-0708 to verify your specific coverage before your first appointment.
Frequently Asked Questions
How quickly will my referral be processed?
Our intake team responds to all referrals within 48 business hours. For urgent situations, please call our office directly.
Can individuals self-refer?
Yes. Individuals and families can contact us directly to request services. A self-referral is welcome and will be processed through the same intake process.
What information do I need to submit a referral?
Basic demographic information, contact details, insurance information, and a brief description of the clinical need are most helpful. The more information you can provide, the faster we can process the referral.
Do you accept emergency or crisis referrals?
For mental health crises, please call 988 (Suicide & Crisis Lifeline) or 911. For urgent (non-emergency) referrals, please call our office directly at (336) 887-0708.
What geographic areas do you serve?
We primarily serve Guilford County and surrounding counties in North Carolina. Contact us to discuss services in your specific area.