Providers & Referrals

Submit Your Referral for Care


Refer your client to Axiom Care by simply filling out the form below.

Axiom Care is a behavioral health provider for men and women suffering from Substance Use Disorder; we are contracted with all 7 AHCCCS Medicaid Health Plans in Arizona and can also provide services to Native American clients under the American Indian Health Plan (AIHP) and can accept cash payment. We offer a full array of detox services and can provide residential substance use disorder treatment at our men’s 24-bed (RTC) Whitton facility in Phoenix.

If a client does not have Medicaid Insurance, one of our staff members can assist with an application.

Client Referral Form

Client Name(Required)
MM slash DD slash YYYY
Point of Contact Name(Required)

If you would like to make a referral to Axiom Care for the Men’s RTC, please contact our intake team to check on bed availability and provide the information/documentation below.

INTAKE PACKET TO INCLUDE:

  • Completed Axiom Care Referral Form
  • Current Medication List
  • Current ASAM
  • Current Diagnosis
  • Details Of Qualifying Insurance
  • Current TB Test
  • Paper Prescriptions
  • Documentation That Client Is Medically Cleared For Residential Treatment

EMAIL TO: INTAKE@AXIOMCAREOFAZ.COM

Contact the team directly at:
602-875-0409

Once the intake packet is complete, bed availability will be confirmed, and an intake transfer will be arranged to ensure the client has a warm handoff to our facility.

For Residential SUD Treatment, the length of stay will depend on the individual needs of the clients.  All treatment is regularly reviewed with the Health Plans, an Individual Service Plan (ISP) is completed and the clients are involved in all aspects of the discharge planning process.

Please read the information below on items allowed/not allowed while at the RTC:

ALLOWED

Appropriate clothing needed for 3-4 days (laundry services on site)

Personal hygiene/ toiletry items

Current photo ID

Insurance card

List of prescribed medications

Details of current health care and mental health care providers

NOT ALLOWED

Weapons of ANY KIND

Illicit drugs or contraband

Personal linens (linen is provided)

Outside food/ beverages (all meals and drinks are provided)

We would prefer you not bring any money or valuable items with you

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