
- Our Team
- Clinicians
- Administrative Team
- About Us
- …
- Our Team
- Clinicians
- Administrative Team
- About Us
- Our Team
- Clinicians
- Administrative Team
- About Us
- …
- Our Team
- Clinicians
- Administrative Team
- About Us

Medicaid Referral Form (Accepting new clients)
Please complete the form below by adding the required doctor and paitent information, then fax to our office. The form has been pre-filled with our information for your convenience.
EPSDT Referral Form Required by Medicaid (Ages 5-20 only).
Telehealth services available for all Alabama Medicaid clients 15-20 years of age
Can only be a referral from a Medicaid PCP Approved Provider
(Psychiatrists and PMHNPs cannot refer)
Huntsville Office
115 Manning DR SW
Suite A202
Huntsville, AL 35801
Athens Office
102 Sanders Street
Athens, AL 35611
Contact Us
(256) 489-0046
www.pearlbhs.com