Contact Us

Whether you’re an individual looking for services for yourself or a loved one, a health care provider referring a client, or just searching for more information, we’re here to help.

Take a look at our frequently asked questions for some quick answers.

Still have questions? Give us a call at (888) 224-7312.

I am:* Looking for services for myself Referring a loved one A provider referring a patient

Hidden

formId

Please provide your information:

Your First Name:*

Your Last Name:*

Your phone number:*

Your email address:*

Your relationship to client:

Child

Sibling

Spouse/Partner

Friend

Other

Please provide us with your loved one's information:

Client's first name:*

Client's last name:*

Client's Date of Birth:*

MM slash DD slash YYYY

Client's Street Address*

City*

State*

Zip Code*

Client's phone number:*

Client's email*

The client is aware of this referral and is expecting Forge Health to contact them directly via phone, voicemail, SMS/text, and email as appropriate.*

Yes

Please provide us with your loved one's insurance:

Client's Insurance Type*

Forge Health partners with most major insurance companies. *Medicaid and Medicare are accepted at select locations.

Insurance Provider*

If your insurance provider is not on this list, please select "Insurance Not Listed"

Client's Member ID*

Your member ID can be found on your insurance card. If your member ID is alphanumeric, please include both the letters and numbers you see on your card.

List Insurance Provider Here:*

Please provide the name of your loved one's insurance company and upload images of both the front and back of your insurance cards.

Insurance Card Upload (front)

Max. file size: 256 MB.

Insurance Card Upload (back)

Max. file size: 256 MB.

How can we best support your loved one?

Is the client interested in In-Person or Telehealth services?*

In Person

Telehealth

Is the client interested in services for Mental Health or Substance Use?*

Mental Health

Substance Abuse / Addiction / Alcohol

Other

What type of program are you interested in today?*

Intensive Outpatient Therapy (IOP)

Individual Therapy

Couples Therapy

Family Therapy

Psychiatric Evaluation

Medication Management

Medication Assisted Treatment (MAT)

Tell us a little more about how we can best support your loved one:*

Preferred Location for Services:

Preferred Location for Services:*

Preferred Location for Services:

Preferred Location for Services:*

Preferred Location for Services:

Preferred Location for Services:*

How did you hear about Forge Health?

How did you hear about us?*

Internet Search

Social Media

Healthcare Professional / Organization

Family Member / Friend

Employer / EAP

Insurance Directory / Card

Other

Name of Healthcare Provider or Organization

CAPTCHA

Hidden

formId

Please provide your information:

Your first name:*

Your last name:*

Date of Birth*

MM slash DD slash YYYY

Your phone number:*

Your email address:*

Address*

City*

State*

Zip Code*

I consent to receiving communications from Forge Health via phone, voicemail, SMS/text, and email as appropriate.*

Yes

Please provide your insurance:

Insurance Type*

Forge Health partners with most major insurance companies. *Medicaid and Medicare are accepted at select locations.

Insurance Provider*

If your insurance provider is not on this list, please select "Insurance Not Listed"

Member ID*

Your member ID can be found on your insurance card. If your member ID is alphanumeric, please include both the letters and numbers you see on your card.

List Insurance Provider Here:

Please provide the name of your insurance company and upload images of both the front and back of your insurance cards.

Insurance Card Upload (front)

Max. file size: 256 MB.

Insurance Card Upload (back)

Max. file size: 256 MB.

How can we best support you?

Are you looking for In-Person or Telehealth Services?*

In Person

Telehealth

Are you looking for services for Mental Health or Substance Use?*

Mental Health

Substance Abuse / Addiction / Alcohol

Other

What type of program are you interested in today?*

Intensive Outpatient Therapy (IOP)

Individual Therapy

Couples Therapy

Family Therapy

Psychiatric Evaluation

Medication Management

Medication Assisted Treatment (MAT)

Tell us a little more about how we can best support you:

Location Preference:

Preferred Location for Services:*

Location Preference:

Preferred Location for Services:*

Location Preference:

Preferred Location for Services:*

How did you hear about Forge Health?

How did you hear about us?*

Internet Search

Social Media

Healthcare Professional / Organization

Family Member / Friend

Employer / EAP

Insurance Directory / Card

Other

Name of Healthcare Provider / Employer / Organization*

CAPTCHA

Hidden

formId

Please provide your information:

Your First Name:*

Your Last Name:*

Your phone number:*

Your email address:*

Title:*

Organization, please specify branch if relevant:*

Please provide us with the patient's information:

Patient's first name:*

Patient's last name*

Patient's date of birth:*

MM slash DD slash YYYY

Patient's Address*

City*

State*

Zip Code*

Patient's Email*

Patient's phone number:*

Patient insurance information:

Patient's Insurance Type*

Forge Health partners with most major insurance companies. *Medicaid and Medicare are accepted at select locations.

Patient's Insurance Provider:*

If your insurance provider is not on this list, please select "Insurance Not Listed"

Patient's member ID:*

Your member ID can be found on your insurance card. If your member ID is alphanumeric, please include both the letters and numbers you see on your card.

List Insurance Provider Here:*

Please provide the name of your insurance company and upload images of both the front and back of your insurance cards.

Insurance Card Upload (Front of Card):

Max. file size: 256 MB.

Insurance Card Upload (Back of Card):

Max. file size: 256 MB.

How can we best support your patient?

Is the patient interested in in-person or telehealth services?*

In Person

Telehealth

What is the patient's primary need?*

Mental Health

Substance Abuse / Addiction / Alcohol

Other

Which level of care are your recommending for the patient? (select all that apply)*

Intensive Outpatient Therapy (IOP)

Individual Therapy

Couples Therapy

Family Therapy

Psychiatric Evaluation

Medication Management

Medication Assisted Treatment (MAT)

Tell us a little more about the patient and their current needs:*

Additional Paperwork Upload

Drop files here or

Max. file size: 256 MB, Max. files: 4.

Location Preference:

Patient's Preferred Location for Services:*

Location Preference:

Patient's Preferred Location for Services:*

Location Preference:

Patient's Preferred Location for Services:*

I give or have obtained any necessary consent/authorization prior to disclosing the health information above. The patient is aware of this referral and is expecting Forge Health to contact them directly via phone, voicemail, SMS/text, and email as appropriate.*

Yes

CAPTCHA

Find your location

Forge Health has locations and telehealth services across the Northeast. Click below to find a location near you.

Contact Us

Please provide your information:

Please provide us with your loved one's information:

Please provide us with your loved one's insurance:

How can we best support your loved one?

Preferred Location for Services:

Preferred Location for Services:

Preferred Location for Services:

How did you hear about Forge Health?

Please provide your information:

Please provide your insurance:

How can we best support you?

Location Preference:

Location Preference:

Location Preference:

How did you hear about Forge Health?

Please provide your information:

Please provide us with the patient's information:

Patient insurance information:

How can we best support your patient?

Location Preference:

Location Preference:

Location Preference:

Find your location

View locations