Refer a Patient

Trusted PAS provider since 2018 — Fast, reliable, compassionate care

Why Refer to Treasure Services?

Licensed HCSSA

All Major TX Medicaid MCOs

~300 Attendants — Staff Quickly

EVV Compliant

24-Hour Response

VA Coming Soon

Referral Options

Option A: Quick Referral

Quick 5-minute form for urgent referrals or fast submissions. We'll follow up with you for details.

Option B: PDF Download

Download our referral form, fill it out, and fax it to us.

📄 Download Referral Form (PDF)

Fax to: (409) 853-1791

Option C: Complete Online Form

Submit comprehensive referral information online. We respond within 24 hours.

Option D: Upload Your Form

Already have a referral form from your organization? Upload it here.

Complete Patient Referral Form

Referring Professional

Patient Information

Service Details

Other Ways to Refer

Phone: (409) 853-1371

Fax: (409) 853-1791