For referring providers

Submit a referral

Share the basics below. We keep client information minimal by design and begin matching from there.

If this is an emergency, call 911. If you are in emotional crisis in the U.S., call or text 988.

About you

Full name *

Email *

Phone

Your role *

Your state *

About the client

Minimal by design. Please share only what is listed below.

Client initials *

Initials only — please do not enter full names.

Client state *

Presenting concern *

Insurance *

Preferred language *

Urgency *

Therapist preferences (optional)

Scheduling availability

I understand Therapicker is a referral coordination service, not a therapy provider, and that this information will be shared with potentially matching therapists.