Banyan Telehealth Patient Referral Portal

Complete the form below to submit your referral.

Telehealth Referral

Patient Information

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Provider Information

By submitting this referral, you confirm that all information provided is accurate and complete to the best of your knowledge. You further acknowledge that you are a licensed healthcare provider or a representative of a healthcare organization authorized to coordinate care for the referred patient. The release and exchange of patient health information between Banyan Treatment Centers and your organization is requested solely for the purpose of facilitating treatment, continuity of care, and appropriate clinical coordination for the referred individual.

Telehealth IOP Care Around the Nation for Your Patients

  • In-Network with Most Major Insurances
  • Group & individual therapy multiple times per week
  • Fully virtual access with flexible scheduling
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