Refer A Patient to Serenity Springs

The following form is secured through encryption and is HIPAA compliant. Please contact us with any questions.

By completing the following form, you are authorizing a referral to the providers at Serenity Springs Counseling & Wellness. Please provide complete information so that we can best serve our mutual patient. In lieu of completing some fields you may attach your own referral form. If you include a reference number, we can report back to you that we have received your referral and whether the patient follows through on setting up an appointment. Please contact us with any questions and have a great day!

IMPORTANT! Before checking “Would Like Serenity Springs To Contact Them”, please confirm that the patient has agreed for us to call them.

We are located in the historic Teacherage building at the corners of Academy and Ennis Streets in Fuquay-Varina.

Phone: 919.753.1275
Note: Our phone system is secure and HIPAA compliant so your privacy is assured when leaving us a message.
Email: Contact Us

Please make sure your email address is accurate so that our response is not delayed.

Add files:
(This may be used to upload Intake forms if you already have a confirmed appointment)

If you would like our reply to be encrypted for privacy, please enter a password you will remember below. That password will be required in order to open our email reply.