Make a Referral
By Phone or Email
To make a referral or schedule an appointment in one of IMPOWER’s Outpatient Mental Health Programs by phone or email please contact our Centralized Referrals and Scheduling Department at:
321-639-1224 option 2
Submit a Referral Online
Please print, complete and return by mail or fax to the address on the referral form.
*Note: Adobe Acrobat Reader is required to view PDF files.