You, your loved ones, or someone you know who needs assistance are welcome at Life Recovery Centers.
Simply download the Client Referral Form and the Authorization for Release of Information below.

What is the Process?

Download Forms

If you are a professional referring an individual, please download, fill out, and upload a Release of Information.

Fill Out Forms

Please fill out the Release of Information. If you are unable to provide an ROI for the person you are referring, you are still able to make a referral. 

Upload Forms

Once you have completed the forms, kindly upload and submit them so we can get started with our intake process as soon as possible.

Refer For Yourself

Are you interested in starting services with us? Please fill out the below submission form so we can get back to you as soon as possible! 

Refer For Professionals

Professionals looking to submit a referral for a client please fill out the referral form. 

*Please note, if you are a professional submitting a referral, you do not need to submit an ROI in order to successfully refer a client to services at LRC. However, if we do not receive an ROI for this client, information will not be shared with you.