Exit this survey

1.

We are seeking to improve our community referral database to make the best referrals possible. We frequently refer individuals for several reasons.

• Longer-term or more intensive therapy for Notre Dame students.
• Referrals for spouses, children, or other family members of students, faculty, or staff.
• Providers from other communities seeking local referral recommendations.

If you are interested in receiving referrals from us, please fill out the questionnaire below.

* 1. Please indicate one of the following:

* 2. Contact Information

T