Appointment

Complete these steps for each participant.

1. Participation questionnaire (paper version) Print and complete prior to appointment

2. Referral form completed by; parent/guardian, therapists, school counselors, social workers, and other healthcare professionals. 

if member does not have a case manger (referring behavioral health professional), may use primary care/doctor referral form;

• Banner

• MercyCare

• General referral form

School-Based Universal Referral Form (Completed by student's school counselor or social worker)

3. Schedule an appointment!  Request Appointment [here]

Location: Any Available Location

Select a clinician:

• Mr. Loren Broussard, Peer Support Specialist & Case Manager

or

• Ms. Erica Brown MA, LPC, NCC, Counselor

*Please bring printed documents, personal/school identification card, and current member insurance card to your appointment.