For Referring Providers
Partner With Usto Support Your Patients
We welcome referrals from physicians, psychiatrists, pediatricians, and other healthcare providers across North Carolina. Let's build a collaborative care community together.
Referral Fax Line
Send referral documentation securely — available 24 hours, 7 days a week.
How It Works
Simple, Streamlined Referral Process
We make it easy to refer a patient. From your first contact to your client's first session, our care team handles every step.
Gather Client Information
Collect the required client details listed below — demographics, insurance, and clinical reason for referral.
Send via Fax or Form
Fax documents to 360-530-9343 or fill out our secure online referral form on this page.
We Reach Out to the Client
Our intake team contacts the client within one business day to schedule their initial consultation.
Ongoing Collaboration
With appropriate releases, we can coordinate care and provide progress updates to keep your team informed.
What We Need
Required Client Information
Please include all required fields when submitting a referral. Optional information helps us match the client with the most appropriate therapist.
Client Details
- RequiredFull legal name
- RequiredDate of birth
- RequiredPhone number (client or guardian)
- OptionalEmail address
- OptionalHome address
- OptionalPreferred pronouns / gender identity
- OptionalPreferred language
Insurance & Billing
- RequiredInsurance provider / carrier name
- RequiredMember ID / policy number
- OptionalGroup number
- OptionalSubscriber name (if different from client)
- OptionalSecondary insurance (if applicable)
- OptionalSelf-pay preference (if applicable)
Clinical Information
- RequiredReason for referral / presenting concern
- OptionalRelevant diagnoses (DSM codes welcome)
- OptionalCurrent medications
- OptionalPrevious mental health treatment history
- OptionalUrgency level / safety concerns
- OptionalPreferred therapy format (in-person or telehealth)
Referring Provider Details
- RequiredYour full name and credentials
- RequiredPractice / organization name
- RequiredPhone number
- OptionalFax number for correspondence
- OptionalEmail address
- OptionalNPI number (if coordinating care)
Professional Community
Why Partner With Fresh Breath Therapy?
We're committed to building lasting collaborative relationships with referring providers across North Carolina.
5 Locations Statewide
In-person offices in Cary, Greensboro, Raleigh, Fayetteville, and Wilmington — plus telehealth across all of NC.
Prompt Intake
We aim to contact referred clients within one business day and typically offer an initial appointment within 1–2 weeks.
Licensed Clinicians
Our team includes LCSWs, LMFTs, LCMHCs, and associates — all trained in evidence-based, trauma-informed care.
Coordinated Care
We welcome collaboration. With a signed release, we provide progress summaries and stay in communication with your team.
Broad Insurance Coverage
We accept most major insurance plans. View our full list on the Rates & Insurance page, or call to verify coverage.
Inclusive Practice
Affirming care for all backgrounds, identities, and life experiences — a safe space for every client you send our way.
Online Referral Form
Submit a Referral Securely
Prefer not to fax? Fill out the form below and our intake team will follow up within one business day.
Get in Touch With Our Team
Questions about the referral process? We're here to help.