Online Contact & Referral Form

If you are referring a loved one, please feel free to call us at 412-458-6565 with general questions related to our facility, staff and treatment process.

Your Name*



Type of insurance and plan for payment

Please indicate your relationship to the person you are referring*:
MyselfFamily MemberFriendColleagueOther

Please provide any additional information

Family members and other parties are welcome to contact LaurelCare with referrals, but unless a consent form to release information is signed, no direct treatment-related information can be shared.

We honor and respect clients’, prospective clients’ and all referral parties’ privacy.

outpatient treatment

LaurelCare Treatment Services



8 Hattman Drive
2nd Floor
Kennedy Township, PA 15108


Monday: 9am – 8pm
Tuesday: 9am – 8pm
Wednesday: 9am – 8pm
Thursday: 9am – 8pm
Friday: 9am – 5pm