<div class="embed-responsive embed-responsive-16by9" style="position: relative;padding-bottom: 56.25% !important;"><iframe width="640" height="360" style="max-width: 100%;max-height: 100%; border:none;position: absolute;top: 0;left: 0;width: 100%; height: 100%;" src="https://pcsvideo.pacounseling.com/channel/5eb43d6e1fd78/videoEmbed/679/outpatient-initial-referral-form?modestbranding=1&showinfo=1&autoplay=&controls=1&loop=&mute=&t=0&objectFit=" frameborder="0" allow="fullscreen;autoplay;camera *;microphone *;" allowfullscreen="allowfullscreen" mozallowfullscreen="mozallowfullscreen" msallowfullscreen="msallowfullscreen" oallowfullscreen="oallowfullscreen" webkitallowfullscreen="webkitallowfullscreen" scrolling="no" videoLengthInSeconds="651">iFrame is not supported!</iframe></div>

Outpatient Initial Referral Form

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bzserai@pacounseling.com

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<div class="embed-responsive embed-responsive-16by9" style="position: relative;padding-bottom: 56.25% !important;"><iframe width="640" height="360" style="max-width: 100%;max-height: 100%; border:none;position: absolute;top: 0;left: 0;width: 100%; height: 100%;" src="https://pcsvideo.pacounseling.com/channel/5eb43d6e1fd78/videoEmbed/679/outpatient-initial-referral-form?modestbranding=1&showinfo=1&autoplay=&controls=1&loop=&mute=&t=0&objectFit=" frameborder="0" allow="fullscreen;autoplay;camera *;microphone *;" allowfullscreen="allowfullscreen" mozallowfullscreen="mozallowfullscreen" msallowfullscreen="msallowfullscreen" oallowfullscreen="oallowfullscreen" webkitallowfullscreen="webkitallowfullscreen" scrolling="no" videoLengthInSeconds="651">iFrame is not supported!</iframe></div>

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<a href="https://pcsvideo.pacounseling.com/channel/5eb43d6e1fd78/video/679"><img src="https://pcsvideo.pacounseling.com/videos/video_251031163959_v79d9/video_251031163959_v79d9.jpg?cache=17619304071761930407">Outpatient Initial Referral Form</a>

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[url=https://pcsvideo.pacounseling.com/channel/5eb43d6e1fd78/video/679][img]https://pcsvideo.pacounseling.com/videos/video_251031163959_v79d9/video_251031163959_v79d9.jpg?cache=17619304071761930407[/img]Outpatient Initial Referral Form[/url]

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