CARE ALLIANCE COLLECTIVE

Provider Referral Portal

Securely submit your client referrals to the network.

Important Next Step

What to Expect on the Next Screen

When you click the launch button below, a new tab will open containing a brief gatekeeper screen asking for "Your Name and Email/Phone Number". Please do not put your contact information there. Reference the visual map below to fill out these fields correctly as this ensures all referrals enter the Care Alliance network properly.

Next Screen Preview
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How to Complete Fields
Field 1: Full Name

Patient's Full Legal Name

Input the referred client's complete first and last name.

Field 2: Email or Phone Number

Patient's Email or Phone Number

Input the client's direct personal email address or active mobile phone number.