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Referral Form

We are committed to providing exceptional mental health services to our clients. This referral form has been designed to streamline the process of referring individuals to our practice. Your thoughtful referral ensures that those seeking support receive the care they need in a timely manner

Referral Form

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By submitting this referral form, you acknowledge that you have obtained the necessary consent from the client to share their information for the purpose of this referral. We strive to respond to all submitted referral forms within 24 to 48 hours of submission. 

Get in Touch

At Calvary De'Rosa Counseling and Consulting, we are your partners in navigating life's transitions and fostering improved mental health and overall well-being. Our virtual private practice is committed to providing tailored support for teens and adults. Embrace change, empower growth, and thrive with our compassionate and expert services.

Tel. 337-205-2480
Fax. 337-252-1762
Email: info@calvaryderosa.com
Mailing Address: ​
139B James Comeaux Rd
Lafayette, LA 70508

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