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Provider Resources

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Online Referral Form

Thank you for trusting Alium Health with your patient's continued care.

Please complete the form below and submit directly to Alium.

If you would rather fill out a paper form, please click the button above.

Being referred for:

Submission successful. Thank you for your referral!

Online Referral Form
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We appreciate the opportunity to work with providers in every specialty.  If you have a patient that needs primary care, behavioral health services including SPRAVATO or substance use treatment, please make the referral and know that we will take great care of them. We will report back to you their progress.

Thank you!

Send Medical Records Requests to:
fax: 480-750-0097
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