Banyan Telehealth Patient Referral Portal

Thank you for considering Banyan Telehealth for your patient's care. Please complete the form below to submit a referral. Our goal is to make the referral process simple, efficient, and seamless for our professional partners.

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.