Refer A Patient

Referral information can help the admissions team identify the appropriate program or next level of care.

Professional Referrals

Refer a Patient to Newport

Newport Integrated Behavioral Healthcare welcomes referrals from healthcare professionals, hospitals, emergency departments, behavioral health providers, courts and criminal-justice partners, community organizations, public-health agencies, recovery organizations, and other referral sources.

Complete the secure referral form below and our Admissions Team will review the information and contact you regarding screening, eligibility, availability, and next steps.

Submit a Referral Call Admissions

Immediate Referral Assistance

Need help with a referral right now?

Need immediate assistance with a referral? Call Newport Admissions directly.

(404) 289-8223 Newport Admissions

Secure Professional Referral

Professional Referral Form

Please provide the requested referral information as completely as possible so Newport’s Admissions Team can review screening, eligibility, service availability, and appropriate next steps.

Refer a Patient

Referrer Information

Organization Name(Required)

Type of Organization(Required)

Referring Professional's Name(Required)

First Last

Referring Professional's Title(Required)

Referring Professional's Credentials(Required)

Referring Professional's Location(Required)

City State ZIP Code

Referring Professional's Phone(Required)

Ext.

Referring Professional's Email(Required)

Referring Professional's Fax

Patient Information

Patient Name:(Required)

First Last

Patient Date Of Birth:(Required)

Patient Phone:(Required)

Email Address:

Primary Location:(Required)

City State ZIP Code

Insurance Company Name:(Required)

Member ID #:(Required)

Uninsured patients should still be referred. Eligible individuals with addictive disease treatment needs may qualify for free residential detoxification or outpatient addiction-treatment services at Newport. Our Admissions Team will determine clinical and program eligibility and available funding.

Group # (if available):

Requested Service:(Required)

Preferred Method of Contact:(Required)

Phone

Best Tome to Contact:(Required)

Additional Admissions Information

Looking for another admissions pathway?

Individuals, families, and residential detoxification inquiries can use Newport’s comprehensive Admissions & Referrals page.

Admissions & Referrals

Refer A Patient

Refer a Patient to Newport

Need help with a referral right now?

Professional Referral Form

Refer a Patient

Referrer Information

Patient Information

Looking for another admissions pathway?

Quick Links

Useful Links

Make Appointment

Refer A Patient

Refer a Patient to Newport

Need help with a referral right now?

Professional Referral Form

Refer a Patient

Referrer Information

Patient Information

Patient Does Not Have Insurance

Looking for another admissions pathway?

Quick Links

Useful Links

Make Appointment