WHO WE SERVE

PBH provides outpatient counseling services to children ages 5-9.

Children Counseling

PBH provides outpatient counseling & life coaching services to adolescents ages 10-19.

Pathways Behavioral Health provides outpatient counseling & life coaching services to adults ages 20- .

Adult Counseling

Do you or someone you know need our services?

It all begins here. Complete one of the intake forms below.

Computer Referral Form

Pathways Behavioral Health, INC Client Referral Form

Name

First Name

Last Name

DOB

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DD

YYYY

Gender

Male

Female

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Type of Insurance

Medicaid

Medicare

Private Insurance

No Insurance

Reason for seeking treatment

Referred By

First Name

Last Name

Phone

(###)

###

####

Email

Date Referred

MM

DD

YYYY