Referrals – 1 Balance

Refer a Patient (for providers)

1 Balance is accepting new patients in AZ, CO, MA and SD.

1 Balance is not for everyone; click here to see what we treat.

First Name

Last Name

Patient Location

Patient's Mobile Phone

Patient's Date of Birth

Patient's Insurance Information (optional)

Only in-network plans are listed in the drop-down below. If you don't see your patient's insurance, we're out of network, and they'll have to pay out of pocket. We can assist with out of network reimbursement submissions.

Primary Insurance

Reason for Referral

Referring Practice / Provider Name

Referring Practice / Provider Email

Referring Practice / Provider Phone

How did you hear about us?

Virtual Psychiatry

Refer a Patient (for providers)

Virtual Psychiatry