Agency Referral Forms

Adult Referral

Adolescent Referral

Now Accepting 

 New Patients

Outpatient Behavioral Health

Child & Adolescent Psychiatry & Medication Management 

 Adult Psychiatry & Medication Management

Tele-Counseling & Tele-Psychiatry


Medication Based Therapy Programs

Release of Information

Gambling Treatment

DUI Education

Prevention Program

Adolescent & Family Behavioral Health Program

Call and speak with an intake specialist for referrals and program services today!

(800) 867-2395 or (410)200-9016

Consent To Treatment

​© 2017

Life's Energy Wellness Center Inc.

For more information:

P.O. Box 123

Easton, MD 21601

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