Refer a member

Thank you for trusting Better Life Partners to support the care of the people you serve. Fill out this treatment referral form and we’ll reach out to the member as soon as possible.

Member name(Required)

First Last

Member phone number(Required)

Member DOB

Member insurance carrier

Does the member consent to receiving text messages from Better Life Partners?(Required)

Yes

No

Primary reason you are referring the member

Referring partner name(Required)

First Last

Referring partner phone number(Required)

Referring organization name(Required)

Referring partner email(Required)

Prefer to put a member in touch with us right away?

If the new member has access to their phone and email:

Have them call our engagement line directly to get started: 866-679-0831. That’s it!

If the new member does not have access to a phone and email:

Print our Treatment Agreement and Release of Information and get the new member’s signature
Fax the signed ROI and treatment agreement to 802-332-3317 or, email the signed ROI and treatment agreement to records@betterlifepartners.com
Call our member engagement line on behalf of the member: 866-679-0831. We’ll take it from there!

Why Better Life Partners?

Same-day treatment

Compassion at every step

Community support

“You always make sure I get my medicine even if I miss the meeting and the ability to do make up meetings is extremely helpful.”

– Better Life Partners member in Maine