To learn more about our services or to discuss a case, please complete this confidential form and one of our admission coordinators will get back to you. If you have a patient who is in crisis, please seek immediate care at a local hospital emergency room or call 911.First Name(Required) Last Name Initial Organization(Required) Role(Required) Contact Phone Number(Required)Email What is the best way to contact you? Cell phone number Email Best time to contact you?(Required) Hours : Minutes AM PM AM/PM Are you reaching out today to make a referral to:(Required) Inpatient Psychiatric Care for an Adult Inpatient Psychiatric Care for an Adolescent Inpatient Psychiatric Care for a Child Additional Information or Questions: Thank you! TaraVista Behavioral Health Center 85 Patton Road Devens, MA 01434 www.taravista.care
