Introducing Beth Collins, LCSWA Message from Our Executive Director
Phoenix Rising Behavioral Services, LLCPhoenix RisingBehavioral Services, LLC

For care providers and case workers

Refer someone to our team

Complete the clinical referral and intake form and it is sent directly to our team. We review the details you share and follow up using the contact information you provide.

Prefer to talk first? Call us at 207-203-0092.

Families can also find us on Facebook.

1. Referral Source & Requested Clinical Service

Services requested (select all that apply)

2. Client Information & Demographics

Preferred session modality

3. Insurance & Payment Coverage
4. Clinical Focus & Reason for Referral

Primary symptoms / concerns (check all that apply)

5. Basic Needs & Community Resource Navigation

We believe mental health begins with physical security. Check any areas where the client may benefit from direct navigation and coordination with community partners.

Housing Security

Heating & Utilities

Food & Nutrition

Community & Case Management

6. Safety, Pacing & Consent for Care

By submitting, you authorize Phoenix Rising Behavioral Services to contact the listed parties to coordinate assessment scheduling and intake review. Our clinical staff upholds strict HIPAA guidelines and respects client autonomy and pace at all times.

Prefer to fax? Send completed forms to 207-742-4231. See how we handle what you send in our privacy notice.