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Intake & Referrals • Structured • Low-PII

Intake & Referrals

Use this page for structured requests, referral coordination, and getting started with peer support. For fastest support, call or text us directly.

Business Hours: Mon–Fri 8:00 AM–5:00 PM • 24/7 peer support by text
Crisis & Safety
Not for emergencies. Call 911 for immediate danger. Call or text 988 for crisis support.
Privacy note
Please do not include sensitive personal health information in web/email messages. Review our Privacy & HIPAA Notice.

How to use Intake & Referrals

If you are seeking services for yourself
  • Share your name and best callback method
  • Tell us what type of support you want (general)
  • We will contact you to confirm next steps
If you are making a referral
  • Provide your name/role and contact info
  • Provide the participant’s name + safe callback method
  • Keep details minimal; we will coordinate directly

Structured request form (low-risk)

This form is designed to collect only what we need to reach you. Please keep your message general.
Prefer not to use the form? Call/text (910) 467-8653.
Note: This low-risk form opens your email client to send the request. It does not store sensitive details in a web database. For secure workflows, use the Secure Portal.

What happens next

  1. We confirm contact details and the best way to reach you.
  2. We clarify goals and identify the right support approach.
  3. We schedule next steps and explain what to expect.
Response times vary. Calls and emails are typically answered during business hours; text support is available 24/7.