Special October Event Coming Soon — Click to Join the Priority List!
Partner With Emerging Hearts

Therapy Referral Form

We welcome referrals from physicians, psychiatrists, healthcare organizations, churches, universities, schools, and community partners across North Carolina. Self-referrals and family referrals are also gladly accepted.

All submitted information is handled with strict confidentiality. Once received, our clinical team will reach out to the client within 1 to 2 business days.

1. Referral Source Information

(If you are referring yourself or a loved one, you may enter "Self-Referral" below.)

2. Client Information

3. Services Requested (Select All That Apply)

4. Primary Concerns & Reason for Referral

5. Insurance & Payment Preference

Special Event Announcement

Emerging Whole: Fall Wellness Gathering

Join Torrie Powell, LCSW, LCAS, ICAADC this October for a transformative faith-integrated workshop focused on emotional healing, spiritual renewal, and practical wellness tools.

October 2026
Details Launch Sept 14
Virtual & Community Event

Advertising officially opens on September 14. Spots are limited! Enter your name and email below to receive priority registration and early-bird access.

We respect your privacy. You will only receive updates regarding this October gathering.