Peers.net Referral Form

Peers.net is a HIPAA-compliant telehealth platform where teens and young adults (ages 13-30) can get 1:1 online professional peer support through video, audio, or messaging.

The person you are referring will be contacted within 2 business days once you submit this form. If you have any additional questions or want to share any additional information about the person you are referring to Peers.net, please reach out to us at referrals@peers.net. If you are referring yourself, and are experiencing a mental health crisis, call or text 988.

If you'd prefer to share a referral via phone or fax, you can do so using the numbers below:

Phone: (415) 725-5422

Fax: (415) 326-7826

Learn more about peer support on Peers.net

We’re here to support your clients through every step of their mental health journey, and do our best to mitigate challenges found in the status quo.

We treat individuals across the full acuity spectrum, including those experiencing SUD and suicidal ideation

Fast access with <24 hrs booking availability

Youth get to choose their peer supporter based on shared identity / experiences

Session times are available between 6am - 10pm PST / 9am - 1am EST

Information about the person making the referral (you!)

Your name

Your email

What’s your relationship to person you’re referring?

Information about the person you’re referring to Peers.net

Legal first name

Legal last name

Preferred name

Phone number (put N/A if unavailable)

Email (put N/A if unavailable)

Date of birth (if available); reminder that we serve individuals 13-30

Optional: Insurance information

Name of Health Plan (if available)

Insurance Member ID (if available)

Optional: Community Health Worker (CHW) Eligibility Criteria
*This is only required for Carelon referrals.

Select the criteria met for this referral

Optional: Referral notes