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AGENCY REFERRAL

This form is for agency referrals only. Please do not use this form if you are the client. 

INSTRUCTIONS: STEP 1-Please submit the form below to refer your agency's client to Teras. 

STEP 2-Use the myfax button to the right to upload and fax digital documents (pdf's) securely to Teras 
ATTN: THE MYFAX BUTTON ONLY ACCEPTS ONE PDF document per submission.
If you have multiple documents that can't be consolidated into one-use the fax number above the button 503-715-5672 and send through your fax machine. 

Thank you for referring to Teras!  

Referral Form