New Member Referral

For use by licensed mental health professionals

Dear mental health professional:

Thank you for your interest in referring a prospective member to the Academy. We are pleased to offer an encrypted, secure electronic submission option. Please complete the online form below. Items marked with an (*) are required.

Alternatively, you can print our new member referral form and return it to us by regular mail, confidential fax, or drop it off at one of our locations.

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Referral Form

Step 1 of 3: Prospective member information

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You're invited!

Stop by and see what we're all about

We welcome you to come take a tour of the Academy. See the teams in action and enjoy a healthy lunch prepared onsite. To better accommodate you, appointments are preferred.

Schedule a tour Contact us
You're invited!

Sarasota Campus

1910 Glengary St.
Sarasota, FL 34231
(941) 921-9930

Bradenton Campus

601 12th Street West
Bradenton, FL 34205
(941) 921-9930

The journey to recovery starts here.

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The Academy at Glengary, Inc., is a 501(c)(3) charitable organization. All donations are tax-deductible to the extent allowed by law. The Academy at Glengary is registered with the state of Florida (CH56160). A copy of the official registration and financial information may be obtained from the Division of Consumer Services at www.fdacs.gov/ConsumerServices or by calling toll-free 800-435-7352 within the state. Registration does not imply endorsement, approval, or recommendation by the state.

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