You can complete our Referral Form in one of three ways:


  1.  Complete the Online Form below:


Online Referral Form



  2.  Download the Referral Form below:

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Please FAX form to: 702.228.8248 or email to:


  3.  Call Us Today: We will walk you through the Form:


Our Admissions Department is available to answer any questions regarding Eagle Quest’s programs and services and to help ensure you are provided information to best meet your needs. Referrals can be made by calling Admissions directly Monday through Friday between the hours of 8:00 AM to 5:00 PM.

Call Today! 702.646.5437

Eagle Quest

Eagle Quest