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Referral:
Accessible Out-Patient Rehab in Calgary

At Blink Integrative Mental Health, we make accessing personalized care simple and inclusive. Referrals to our Calgary outpatient rehab can be made by professionals such as nurses, physicians, or social workers. However, clients can also self-refer directly, ensuring no barriers to starting recovery. Employers may submit referrals on behalf of employees with their agreement, offering additional support options. Our streamlined, confidential process ensures you can begin your tailored recovery journey with ease, prioritizing your well-being and lasting success.

Take the First Step Toward Recovery Today

Ready to begin your journey with our Calgary out-patient rehab program? Whether you’re self-referring or being referred by a professional or employer, we’re here to make the process easy and supportive. Complete the form below to get started on your personalized recovery plan

Phone

403-870-53-53

Email

info@blinkmhc.com

Referral Source

Who is making this referral?

Client Information

Birthday

Services Requested

Which services are you seeking?
Substance Use History
How long have you been using the substance(s)?

Previous Treatment History:

Have you received treatment for substance use before?
Required Start Date

Duration of Use:

Have you received mental health treatment before?
☐ Yes
☐ No
If Yes (please specify where and when):

Frequency of Use

How often do you use the substance(s)?

Current or Recent Substance Use:

When was the last time you used the substance(s)?

Impact of Substance Use:

Have you experienced any of the following as a result of substance use? (Check all that apply):

Professional or Employer Information (if applicable)

Client Agreement: Has the client agreed to this referral?
Yes
No
Payment: Who will pay for treatment?
Employer
Employee
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