Collaborate With Us!

Please share your contact info, (and if relevant your client or patient's information) and any questions or concerns you have.

Once you submit this HIPAA-encrypted form, our team will reach out to you within 48 business hours to confirm receipt and discuss next steps.

We always welcome your communication, by any method you choose:

Use this HIPAA encrypted form (below) as often as needed
Call us on our HIPAA encrypted line at 747-212-3876, option 3 (our dedicated collaboration line)
Email us at [email protected] (though email is not HIPAA secure)
Fax (HIPAA secure): 313-788-8469

We look forward to collaborating with you!

First Name *

Last Name *

Email *

Phone *

Profession *

Patient/Client- related information or question.

File upload (optional) Examples: Patient release form

Receive Messages

By checking this box, I consent to receive marketing and educational messages from Remedy, including the monthly evidence-based Remedy educational newsletter for mental health professionals. I understand that I can opt out and unsubscribe at anytime. (Optional)

By checking this box, I consent to receive messages related to services I have requested, including requests to collaborate in patient care. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out. (Required for us to contact you)