Make a Referral, Sign Up for Services

Forms

Complete this quick verification form and we will get back to you with information on how to start your treatment journey with us.

Fill out one form for each person who would like to start services (example: multiple siblings)

Complete this full intake form to quickly get an initial appointment if you already know you want to start right away. We will call you within 2 business days to schedule your first appointment.


Fill out one form for each person who would like to start services (example: multiple siblings)

Please Fax Any Records Related To Referrals To: 281-503-7905 Or Secure Email: aburns@alpharecoverytexas.com