Contact Us At
BasePoint Academy

Discover What Teenage Mental Health Conditions We Treat at BasePoint Academy

Our Locations

Arlington, TX

Forney, TX

Frisco, TX

McKinney, TX

Call Us

(972) 357-1749

Admission Hours

7:00 am to 7:00 pm

7 Days a week

provider Referral form

Please use this form to provide information on clients you are referring to BasePoint. Our goal is to make this process simple for you.

Your Information
Your Full Name (First & Last)*
Your Organization*
Your Email*
Your Phone Number*
Is this your first time referring to BasePoint?*
Patient Information
Patient Name (First & Last)*
Patient Date of Birth*
MM slash DD slash YYYY
Patient Insurance Provider*
Any other relevant information (optional)
Parent / Guardian Contact Information
Parent / Guardian Name (First & Last)*
Parent / Guardian Email*
Parent / Guardian Phone Number*
Who should BasePoint Reach Out To?
Who should BasePoint Reach Out To?*
Preferred Method of Contact?*
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Contact Us AtBasePoint Academy

provider Referral form

Your Information

Patient Information

Parent / Guardian Contact Information

Who should BasePoint Reach Out To?

Free Mental Health Assessment

Contact Us At
BasePoint Academy