Referring Customers Only

Please complete the required fields and attach the Release of Information (ROI). Referrals are typically processed within 1-2 business days. If you would like to use your own referral form, please submit the referral to Thank you.

Referral Form

SAGE Counseling does not accept cash or check payment for services.
We do accept money orders and all credit and debit cards bearing a Visa, Mastercard, American Express or Discover logo. Payment is also accepted in the form of a money order, postal money order, or cashier's check
If your referral would like to prepay for services at SAGE, please have your referral contact SAGE at (480) 649-3352 or visit our online payment page, here.
If you have questions about submitting a referral please contact SAGE Counseling at (480) 649-3352. If you have technical issues in the process of submitting a referral please, contact SAGE IT at (602) 761-4920 or by emailing us at