Referral Form
Mountainside Counseling Services
Get In Touch
If you're a healthcare provider, school counselor, or mental health professional looking to refer a client to Mountainside Counseling Services, please use the secure referral form below. We welcome collaboration with physicians, educators, and care teams to ensure clients receive the support they need.
Our therapists specialize in treating a range of concerns including anxiety, depression, trauma, eating disorders, parenting stress, and more—offering both in-person and virtual therapy options for individuals, children, teens, and families across Davis County and surrounding areas.
To protect client privacy, this form is hosted on a secure, HIPAA-compliant platform. Any Protected Health Information (PHI) submitted will be handled in accordance with federal privacy guidelines. Please review and check the consent box at the bottom of the form before submitting.
Thank you for trusting us with your referral. We will follow up with you or the client promptly.